Papafragkakis
Charilaos Papafragkakis, MD
Gastroenterologist - Hepatologist

Acute Pancreatitis

The pancreas is an organ, about 15 centimeters in length, deep inside the upper abdomen. It is surrounded by the vertebral column, stomach, small intestine, liver and spleen. The pancreas produces and releases digestive enzymes and hormones. Main functions of the pancreas are digestion of food and regulation of blood sugar.

 What is Acute Pancreatitis?

Acute pancreatitis is the inflammation of the pancreas. It can cause sudden and intense abdominal pain with vomiting. Stones in the bile ducts and alcohol use are the most common causes. Other causes are very high triglyceride levels, drugs, various biliary diseases, viral infections, and so on. In a significant number of cases the cause is unknown and is probably associated with genetic predisposition.

What are the symptoms?

The most common presentation is stomach pain that can last for several days. It may be continuous and may radiate to the back. The pain may be sudden or may start slowly and worsen after eating. Other symptoms may include nausea, vomiting and fever.

How to diagnose acute pancreatitis?

The diagnosis is usually made when there is a history of acute abdominal pain and an increase in pancreatic enzymes. CT scan of the abdomen is useful in these cases.

What is the treatment?

Patients with pancreatitis usually get hospitalized. Treatment depends on the severity of the symptoms. Mild cases may respond to basic supportive care. This includes bowel rest, intravenous fluids and analgesics. The patient can start a liquid diet when the pain has subsided, has no nausea or vomiting or begins to feel hungry.

For moderate or severe cases very close monitoring is required. In such situations, there is a risk of multi-organ failure and other complications. Complications of severe pancreatitis may include infections, cyst formation or even bleeding.

If pancreatitis is due to stones, then it may be necessary to have them removed by a specific endoscopic procedure called ERCP. In some cases patients with stone-induced pancreatitis may also undergo surgical removal of the gallbladder to avoid future pancreatitis episodes.

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