Acute Pancreatitis

Inflammation of the pancreas is called pancreatitis. The pancreas is a gland that is located behind your stomach and close to the first part of the small intestine, which is called the duodenum. The pancreas releases powerful digestive enzymes into the small intestine through a duct. Pancreatitis occurs when these digestive enzymes are activated and begin attacking the pancreas. There are two forms of pancreatitis. The acute form occurs suddenly and may be a severe, life-threatening illness with many complications. If injury to the pancreas continues, a chronic form of pancreatitis may develop.

An estimated 50,000 to 80,000 cases of acute pancreatitis occur in the United States each year.

Most cases of acute pancreatitis are caused either by alcohol abuse or gallstones. Other causes may be prescribed drugs, trauma or surgery to the abdomen, or abnormalities of the pancreas or intestine. In rare cases the disease may result from an infection such as mumps. In about 15% of cases, the cause is unknown.

Pancreatitis is not contagious and usually resolves after gallstones are removed or if the patient abstains from alcohol use.

Living With Your Diagnosis
Acute pancreatitis usually begins with pain in the upper abdomen; this pain may last for a few days and is often severe. It may be constant pain that is just in the abdomen, or it may reach to the back and other areas. The pain may be sudden and intense, or it may begin as a mild pain that is aggravated by eating and slowly grows worse. The abdomen may be swollen and very tender. Other symptoms may include nausea, vomiting, fever, and an increased pulse rate. The person with this condition often feels and looks very sick.

About 20% of pancreatitis cases are severe. The patient may become dehydrated and have low blood pressure. Sometimes the patient's heart, lungs, or kidneys fail. In the most severe cases, bleeding can occur in the pancreas, and this can lead to shock and sometimes death.

Acute pancreatitis is detected by a blood test that checks the body's level of amylase (a digestive enzyme formed in the pancreas), which is elevated during an acute attack. Changes may also occur in blood levels of calcium, magnesium, sodium, potassium, and bicarbonate. In addition, patients may have high amounts of sugar and lipids (fats) in their blood. After the pancreas recovers, blood levels of these substances usually return to normal.

Treatment
The treatment of acute pancreatitis is supportive in most cases. Usually the patient will be admitted to the hospital. The doctor prescribes intravenous fluid administration to restore blood volume, and the kidneys and lungs may be treated to prevent their failure. Other problems, such as cysts in the pancreas, may need treatment as well.

Sometimes a patient cannot control his or her vomiting and needs to have a tube passed through the nose to the stomach to remove fluid and air. In mild cases a patient may not be able to eat for 3 or 4 days but is given fluids and pain relievers by vein. An acute attack usually lasts only a few days unless the pancreatic ducts are blocked by gallstones. In severe cases a patient may be fed through the veins for 3 to 6 weeks while the pancreas slowly heals.

Antibiotics may be given if signs of infection arise. Surgery may be required if complications such as infection, cysts, or bleeding occur. Attacks caused by gallstones may require removal of the gallbladder or surgery of the bile duct. When there is a severe injury that includes the death of tissue, an operation may be performed to remove the dead tissue.

The Dos

  • Remember that pancreatitis can be a life-threatening disease that may require prolonged hospitalizations.
  • Follow up with your physician after discharge from the hospital. Sometimes acute pancreatitis can progress to chronic pancreatitis and will require medications.
  • Realize that alcohol may be a problem.

The DON'Ts

  • Don't drink alcohol.
  • Don't eat fatty foods.
  • Don't be afraid to ask for help if you cannot stop drinking alcohol.

When to Call Your Doctor

  • If you have abdominal pain.
  • If you are vomiting blood.
  • If you have a problem with alcohol.
  • If you have diarrhea.
  • If you are having fever with nausea and vomiting.


For More Information
National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892-3570

 

 

Derived from Patient Teaching Guide, © Mosby, Inc. All Rights Reserved

 

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