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Acute pancreatitis is sudden swelling and inflammation of the pancreas.
Causes, incidence, and risk factors
The pancreas is an organ located behind the stomach that produces chemicals called enzymes, as well as the hormones insulin and glucagon. Most of the time, the enzymes are only active after they reach the small intestine, where they are needed to digest food.
When these enzymes somehow become active inside the pancreas, they eat (and digest) the tissue of the pancreas. This causes swelling, bleeding (hemorrhage), and damage to the pancreas and its blood vessels.
Acute pancreatitis affects men more often than women. Certain diseases, surgeries, and habits make you more likely to develop this condition.
The condition is most often caused by alcoholism and alcohol abuse (70% of cases in the United States). Genetics may be a factor in some cases. Sometimes the cause is not known, however.
Other conditions that have been linked to pancreatitis are:
Other causes include:
The main symptom of pancreatitis is abdominal pain felt in the upper left side or middle of the abdomen.
People with acute pancreatitis often look ill and have a fever, nausea, vomiting, and sweating.
Other symptoms that may occur with this disease include:
Signs and tests
The doctor will perform a physical exam, which may show that you have:
Laboratory tests will be done. Tests that show the release of pancreatic enzymes include:
Other blood tests that can help diagnose pancreatitis or its complications include:
Imaging tests that can show inflammation of the pancreas include:
Treatment often requires a stay in the hospital and may involve:
Occasionally a tube will be inserted through the nose or mouth to remove the contents of the stomach (nasogastric suctioning). This may be done if vomiting or severe pain do not improve, or if a paralyzed bowel (paralytic ileus) develops. The tube will stay in for 1 - 2 days to 1 - 2 weeks.
Treating the condition that caused the problem can prevent repeated attacks.
In some cases, therapy is needed to:
In the most severe cases, surgery is needed to remove dead or infected pancreatic tissue.
Avoid smoking, alcoholic drinks, and fatty foods after the attack has improved.
Most cases go away in a week. However, some cases develop into a life-threatening illness.
The death rate is high with:
Pancreatitis can return. The likelihood of it returning depends on the cause, and how successfully it can be treated.
Repeat episodes of acute pancreatitis can lead to chronic pancreatitis.
Calling your health care provider
Call your health care provider if:
You may lower your risk of new or repeat episodes of pancreatitis by taking steps to prevent the medical conditions that can lead to the disease:
Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-2400.
Frossard JL, Steer ML, Pastor CM. Acute pancreatitis. Lancet. 2008;371:143-152.
Owyang C. Pancreatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 147.
Reviewed by:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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