Pancreatitis

Pancreatitis

National Digestive Diseases Information Clearinghouse

What is pancreatitis?
U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum—the first part of the small intestine. The pan­ creas secretes digestive juices, or enzymes, into theduodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile—a liquid produced in the liver and stored in the gallbladder—to digest food. The pancreas also releases the hor­ mones insulin and glucagon into the blood­ stream. These hormones help the body regulate the glucose it takes from food for energy. Normally, digestive enzymes secreted by the pancreas do not becomeactive until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them. Pancreatitis can be acute or chronic. Either form is serious and can lead to complica­ tions. In severe cases, bleeding, infection, and permanent tissue damage may occur. Both forms of pancreatitis occur more often in men than women.

Liver

Hepaticducts Cystic duct

Gallbladder Pancreas Duodenum Common bile duct Pancreatic duct

The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system.

What is acute pancreatitis?
Acute pancreatitis is inflammation of the pancreas that occurs suddenly and usually resolves in a few dayswith treatment. Acute pancreatitis can be a life-threatening illness with severe complications. Each year, about 210,000 people in the United States are admitted to the hospital with acute pancreatitis.1 The most common cause of acute pancreatitis is the presence of gallstones—small, pebble-like substances made of hardened bile—that cause inflam­ mation in the pancreas as they pass through

1 RussoMW, Wei JT, Thiny MT, et al. Digestive and liver disease statistics, 2004. Gastroenterology. 2004;126:1448–1453.

the common bile duct. Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors, and genetic abnormalitiesof the pancreas.

Diagnosis
While asking about a person’s medical his­ tory and conducting a thorough physical examination, the doctor will order a blood test to assist in the diagnosis. During acute pancreatitis, the blood contains at least three times the normal amount of amy­ lase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such asglucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person’s condi­ tion improves, the levels usually return to normal. Diagnosing acute pancreatitis is often dif­ ficult because of the deep location of the pancreas. The doctor will likely order one or more of the following tests: • Abdominal ultrasound. Sound waves are sent toward the pancreas through a handheld device that atechnician glides over the abdomen. The sound waves bounce off the pancreas, gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture—called a sonogram—on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off them, showing their location.

Symptoms
Acute pancreatitis usually begins with grad­ ual or sudden painin the upper abdomen that sometimes extends through the back. The pain may be mild at first and feel worse after eating. But the pain is often severe and may become constant and last for sev­ eral days. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symp­ toms may include • a swollen and tender abdomen • nausea and vomiting •...