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Acute Pancreatitis

Definition

The pancreas is a long, flat, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones, including insulin. Acute pancreatitis is inflammation of the pancreas that occurs suddenly and resolves with proper treatment.
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Pancreatitis
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Causes

Pancreatitis occurs when digestive enzymes are activated in the pancreas instead of the small intestine. Acute pancreatitis has several causes. In some cases, the cause may be unknown.
Known causes of acute pancreatitis include

Risk Factors

Factors that may increase your risk of acute pancreatitis include:

Symptoms

Symptoms may occur one time or many times. Repeated flare ups of symptoms are known as attacks.
Acute pancreatitis may cause:
Untreated acute pancreatitis may progress into chronic pancreatitis , a serious condition where the pancreas becomes permanently damaged.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will ask how much alcohol you drink and what medications you take. Diagnosis can be determined by your symptoms and results from blood tests.
Your body fluids may be tested. This can be done with:
Images may be taken of your body structures. This can be done with:

Treatment

Treatment for acute pancreatitis depends on the severity of the attack and what is causing it. For example, if medication is the cause of your pancreatitis, your doctor may change to a different medication or adjust the dose.
In most cases, acute pancreatitis isn't severe and can be treated. Treatment includes:

Hospitalization

Generally, acute pancreatitis treatment requires hospitalization. Fluid and nutritional support can be given by IV while your pancreas heals. During this time, you will be unable to eat or drink. Supplemental oxygen may also be given.
If you have severe pancreatitis, you may need a nasogastric tube. A long, thin tube is threaded through your nose and into your stomach for feeding.
You may also start treatment for any underlying causes of your pancreatitis.

Medications

Your doctor may recommend:
  • Antibiotics—to treat any infections
  • Pain medications
  • Protease inhibitors—to reduce the effects of digestive enzymes
  • Insulin—to help regulate blood glucose levels

Surgery

In general, surgery isn't necessary for mild pancreatitis. It may be necessary when medical treatment doesn't work for more severe cases. Surgery may also be used to treat underlying conditions.
Surgical procedures include:
  • Necrosectomy—Removal of dying or dead (necrotic) pancreatic tissue. Pancreatic necrosis is more serious if an infection is present. This procedure can also be done with endoscopy.
  • Percutaneous catheter drainage—One or many thin tubes are inserted into the abdomen to drain fluid from the pancreas.
  • ECRP—To remove gallstones or open any collapsed ducts.
  • Cholecystectomy —To remove the gallbladder.

Prevention

To help reduce your chance of getting acute pancreatitis, take these steps:

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov

National Pancreas Foundation http://www.pancreasfoundation.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology http://www.cag-acg.org

Health Canada http://www.hc-sc.gc.ca

References

Acute pancreatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 2, 2014. Accessed December 11, 2014.

Acute pancreatitis. Tulane University School of Medicine website. Available at: http://tulane.edu/som/pancreas-biliary/diseases/acute-pancreatitis.cfm. Accessed December 11, 2014.

Causes of acute pancreatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 31, 2013. Accessed December 11, 2014.

Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis. Updated August 16, 2012. Accessed December 11, 2014.

Prevention of acute pancreatitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 7, 2014. Accessed December 11, 2014.

4/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Baker ME, Nelson RC, et al. ACR Appropriateness Criteria for acute pancreatitis. American College of Radiology (ACR); 2013. 11 p. Available at: http://www.guideline.gov/content.aspx?id=47649. Accessed April 7, 2014.

8/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Johnson CD, Besselink MG, et al. Acute pancreatitis. BMJ. 2014 Aug 12;349:g4859.

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