Acute Pancreatitis - Causes, Symptoms & Treatment

Acute pancreatitis is sudden inflammation of the pancreas that may be mild or life threatening but that usually subsides. About 80,000 cases occur in the United States each year some 20 percent of them are severe. Acute pancreatitis occurs more often in men than women.

Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but these aren't the only causes. If alcohol use and gallstones are ruled out, other possible causes of pancreatitis should be carefully examined so that appropriate treatmentif available can begin. Normally, the pancreas secretes pancreatic fluid through the pancreatic duct to the duodenum. This pancreatic fluid contains digestive enzymes in an inactive form and inhibitors that inactivate any enzymes that become activated on the way to the duodenum. Blockage of the pancreatic duct by a gallstone stuck in the sphincter of Oddi stops the flow of pancreatic fluid. Usually, the blockage is temporary and causes limited damage, which is soon repaired. But if the blockage continues, activated enzymes accumulate in the pancreas, overwhelm the inhibitors, and begin to digest the cells of the pancreas, causing severe inflammation.

The most common first symptom is abdominal pain, often accompanied by vomiting, fever, tachycardia (racing of the heart), high white blood cell count and increased levels of pancreatic enzymes in the blood and urine. In severe cases, acute pancreatitis affects other organs, (e.g., lungs, kidneys, liver, the cardiovascular and central nervous systems). Acute pancreatitis can be further subdivided into mild and severe: in the mild form, the disease causes little organ dysfunction and the body recovers more or less on its own; in the severe form, the disease causes multiple organ failure, tissue death, abscesses and pseudocysts.

The pancreas is an elongated organ that lies in the back of the mid-abdomen. It is responsible for producing digestive juices and certain hormones, including insulin, the main hormone responsible for regulating blood sugar. Pancreatitis can be acute or chronic. Acute pancreatitis occurs as one sudden episode. After acute pancreatitis the pancreas usually returns to its normal condition.

Chronic pancreatitis means ongoing or repeated bouts of pancreatitis in which there is permanent damage to the pancreas. Pancreatitis can be acute appearing suddenly and lasting for a few days or it can be chronic, developing gradually and persisting over many years. Both acute and chronic pancreatitis are marked by mild to severe abdominal pain, often with nausea, vomiting and fever. And both can lead to serious complications. Heavy alcohol use and gallstones are the primary causes of pancreatitis, but other factors, including certain medical conditions, some drugs and genetic mutations also can lead to the disorder. Sometimes the cause is never found. Mild attacks of acute pancreatitis often improve on their own or after simple dietary changes, but more severe cases may require immediate medical care to avoid fatal complications.

Causes of Acute Pancreatitis

Most cases of chronic pancreatitis are caused by alcohol abuse. The rest are from blockages caused by gallstones, surgical scarring, tumors or an abnormality in the pancreatic duct. Though rare, some cases develop from a genetic disorder or cystic fibrosis, one of the most common hereditary diseases. Other factors include increased triglyceride or calcium level in the blood, viral or bacterial infections, medications (especially estrogens, corticosteroids, thiazide diuretics, acetaminophen or tetracycline), pancreatic surgery, pancreatic injury, peptic ulcers and medical conditions, such as Reye's syndrome, cystic fibrosis and vasculitis . The major cause of Acute pancreatitis is alcohol abuse (in 90 percent of all cases). In the other 10 percent of all cases, chronic pancreatitis is a result of hemochromatosis (excess iron in the body) or heredity.

• Gallstones - blocks the bile duct causing acute pancreatitis .
• Traumatic injury
• Excessive alcohol.
• Pregnany.
• Familial pancreatitis.
• Cystic fibrosis.
• Certain medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine).
• Viral infection ( mumps , coxsackie B, mycoplasma pneumonia , and campylobacter).

Signs and Symptoms of Acute Pancreatitis

The symptoms of acute pancreatitis usually begins with severe pain in the upper abdomen. The pain may last for a few days. Some of the other symptoms of pancreatitis are: swollen and tender abdomen, sweating, nausea, vomiting, fever , mild jaundice , and rapid pulse. About 20 percent of cases are severe. The patient may become dehydrated and have low blood pressure. Sometimes the patient's heart, lungs, or kidneys fail. In the most severe cases, bleeding can occur in the pancreas, leading to shock and sometimes death.

• Fever
• Nausea , vomiting ,
• diarrhea.
• Abdominal tenderness.
• loss of appetite .
• Severe upper left abdominal pain
• Abdominal swelling.
• Sweating .
• Anxiety .

Treatment for Acute Pancreatitis

Treatment may include:

Treatment for Acute Pancreatitis depends on how bad the attack is. If no complications in the form of kidney failure or lung problems occur, acute pancreatitis usually improves on its own. Generally the patient needs hospitalization with administration of intravenous fluids to help restore blood volume. Medication for pain and nausea are provided to ease these symptoms and food is withheld until these symptoms have subsided considerably. Antibiotics are often prescribed in cases of severe acute pancreatitis or if infection occurs. Surgery is sometimes needed when complications such as infection, cysts or bleeding occur. 

• Surgery - if gallstones are present, removing the gallbladder will help prevent further attacks. In rare cases, surgery is needed to remove damaged or dead areas of the pancreas.
• Lifestyle change - eliminating alcohol.
• Fasting and intravenous fluids - until the inflammation settles down.