The pancreas is an organ inside the upper abdomen closer to the back and is part of the digestive and endocrine systems.
The pancreas is vital to the body in 2 ways:
What is acute pancreatitis?
In acute pancreatitis, the pancreas is inflamed due to several factors like alcohol, gallbladder stone or sludge, infections, toxins, genetic abnormalities, high levels of calcium, triglycerides, etc. In some, the cause is not known ( idiopathic).
What happens if pancreatitis occurs?
There are 2 types of pancreatitis – Acute and Chronic. Let us learn a little about Acute pancreatitis in this blog. In acute pancreatitis, there is an acute onset of symptoms after an insult which may be alcohol, gallstones, and others as listed above. The pancreatic injury elicits an inflammatory response and release of pancreatic enzymes and inflammatory chemicals into the surrounding pancreatic tissues, surrounding organs, and the blood. This leads to a cascade of events that may affect the pancreas alone or surrounding tissues or other organs and may even cause death.
What are the symptoms of acute pancreatitis?
A few symptoms of Acute pancreatitis are : Acute pancreatitis leads to severe pain in the abdomen that can radiate to the back, vomiting, refusal of food, etc. Severe cases may have abdominal bloating, breathing difficulty, internal bleeding, other organ failure, and even death.
What are the complications of Acute Pancreatitis?
Some of the complications of acute pancreatitis are abdominal fluid collections like pseudocyst, ascites, pleural effusion, etc, Infected Necrosis and its secondary complications, Diabetes, SIRS, Sepsis, Organ failures like kidney failure, lung failure, heart failure, multi-organ failure, bleeding, splenic infarct, thrombosis of abdominal veins, arterial pseudoaneurysms, intestinal fistula, external fistula etc.
What are the tests done to confirm acute pancreatitis?
Abdominal pain with elevated pancreatic enzymes in the blood test or features of pancreatitis on imaging like Ultrasound or CT scan. As such, a CT scan is more accurate in diagnosis.
How does a doctor assess the severity of the disease?
Clinical examination and the course of events during observation give a big idea about the severity. There are several scoring systems based on clinical, lab tests, and imaging features. Repetition of select tests gives a much clearer view of the progress of the diseases.
Treatment For Acute pancreatitis
Depending on the severity, patients may need outpatient treatment ward admission or ICU admission. In general, patients are asked not to eat or drink to give rest to the pancreas. IV fluids are given. Patient’s vital signs like pulse, BP, saturation etc are monitored. Pain medicines are given. Other medicines are decided based on the condition of the patient. Any inciting agent like alcohol should be immediately stopped. Known common causes are screened for and corrected simultaneously. There is no medicine to halt the course of pancreatitis.
What is the outcome of treatment?
With modern treatment, 80-85 percent of patients recover well in a few days. In some, acute pancreatitis may last for weeks with or without a worsening situation. A crucial factor in good outcomes is identifying the patient who is getting worse during the illness.
Procedure for managing acute pancreatitis?
One or more of the following procedures may be required for managing acute pancreatitis
Surgery may be needed in select patients. See below.
Is surgery required in acute pancreatitis?
In some instances, surgery may be needed. For instance, removal of gallbladder or bile duct stone, managing fluid collections, and various complications of pancreatitis when other measures are not applicable or fail. Mostly nowadays laparoscopic surgery (keyhole surgery) is done in such cases. In some instances, open surgery is the best option.
Can acute pancreatitis come back?
This can happen when the cause of pancreatitis is not corrected. For instance, alcohol, gallbladder stone high triglycerides or high calcium, etc if not corrected, can recur.
Recurrent acute pancreatitis is when repeated attacks of pancreatitis happen and common causes have been ruled out. Rare causes are looked for and treated if possible. Otherwise, treatment is supportive. Some of these patients may enter chronic pancreatitis later in life. See later.
How can one prevent acute pancreatitis?
Where avoidable causes are known, for instance, alcohol, it could be avoided.
