Inflammation of the Pancreas
- Pancreas is an organ located behind
the stomach and next to the liver and the gall bladder.
Pancreatic juices contain enzymes, which help digest or
break down food proteins. Normally the juices leave the
pancreas via a duct like channel and join the common bile
duct, which carries the secretions from the gallbladder, and
pour the mixture into the duodenal portion of the stomach.
- If the pancreas is damaged, the
enzymes leak into the pancreatic tissue and start to
auto-digest (eat itself) the cells, which results in
hemorrhage, swelling, and local destruction within the
pancreas. This process is inflammation. Inflammation of the
pancreas can occur with an immediate injury to the pancreas
(i.e. acute) or with slow, long term damage (chronic).
- Pancreas is also the site where hormones such as Insulin, Glucagon and
somatostatin are produced.
- Flare-ups may have all signs of
- Stools may be oily, fatty and loose.
- Severe abdominal pain that is often
in the middle, may radiate to the back or shoulder:
- Pain may be sharp in nature
- Pain may be worse right after meals (fatty, greasy)
- Abdomen may be bloated, full of gas
- Heartburn or Indigestion
- Clammy cold or sweaty skin.
- Skin or whites of the eyes may be
mildly jaundiced (yellowish)
- There may be bleeding under the skin, Bruising, or rash.
- The stool is clay-colored.
- Chest pain or flank pain (lower
- Discoloration around the umbilicus
- In acute cases, pain subsides within
- Chronic alcohol use
- Accident or trauma
- Abdominal surgery
- With procedures such as ERCP
- Medications such as Tetracycline,
steroids, valporic acid, estrogens, Tylenol and thiazide
- High levels of blood Calcium or
- Hepatitis A and B
- Coxsackie B
- Mycoplasma Pneumonia
- Cystic Fibrosis
- Kawasaki's syndrome
- Hemolytic uremic syndrome
- Reye's syndrome
- Kidney failure
- Scorpion venom
- Polyarteritis Nodosa
- Systemic lupus erythematosus
- Pancreas divisum-pancreatic split
present at birth
- Your doctor may consult with a
radiologist and a digestive diseases specialist known as a
- Medical exam and a full history
reveal risks symptoms and signs mentioned above.
- Blood levels of pancreatic enzymes Amylase and Lipase are often elevated.
- Blood is also sent for kidney tests, cell count, Electrolytes, and
liver and gallbladder functions.
- Blood levels of ALT, AST, Alkaline phosphatase and Bilirubin are often
elevated with liver and gallbladder involvement.
- Glucose and the number of white
blood cells are increased with severe pancreatitis.
- Calcium levels
decrease in severe disease.
- Blood and urine may be tested for
drugs, alcohol or poisoning.
- LDH, Trypsinogen, CEA, and Magnesium levels may
- Stool may be sent for fecal fat
test, which often shows fatty stool especially in the
- Blood samples, urine, and fecal
samples may be sent in cases where an infection is
- X-Rays - Plain radiographs of
the abdomen may show air bubbles in the intestine
- Chronic form may show white areas of Calcium deposits.
- X-Rays of lungs may
show fluid in the acute case.
- Ultrasound uses sound and CAT scan a computer to show a detailed image of the abdomen and the pancreas. In the chronic form they may show small cysts and Calcium deposits.
- ERCP is a procedure in which a GI specialist inserts a flexible tube with a camera at its tip (Endoscope) into the stomach through the mouth and can reach the ducts, inject a dye and take an X-Ray.
- Special tests such as removing
fluid from a cyst in the pancreas can be done by a
radiologist using a CAT scan guided needle
- Drug abuse
- Alcohol use
- Chronic form often in older
individuals > 35-40
- Admission to the hospital is
necessary for acute attacks.
- No food or fluids by mouth until pain
and abdominal symptoms are resolved.
- If vomiting may need a NGT, which is
a tube, passed through the nose into the stomach.
- Painkillers such as Demerol are
- Intravenous fluids are given at a
specific rate via a pump and through a small plastic tube
placed in a vein.
- Blood levels are monitored for Calcium, Magnesium, glucose and
other chemicals and levels adjusted accordingly.
- Antibiotics may be given if
infection is suspected.
- A tube called the urinary catheter
is placed into the urethra and passed into the bladder in
sick patients who need accurate urine volume monitoring.
- In most cases symptoms resolve
within 48 hours.
- Low fat and low protein food and
fluids can be given as tolerated.
- In chronic cases outpatient therapy
- High protein diet and smaller meals
- No alcohol or caffeine.
- If diabetes is present need to control sugars, use Insulin and see a
dietitian for dietary advice.
- Pancreatic enzyme supplementation such as Pancrease MT may help.
- H2 blockers such as Tagamet can help
in reducing stomach acid.
- Must be careful when giving people
with chronic pancreatitis addictive painkillers (Codeine,
Vicodin, Tylenol 3 and 4). Try regular or extra strength
- In some acute or chronic cases
surgery may be needed to remove a stone, gallbladder, drain
a cyst or open a blocked duct.
- Blood tests and radiographs may need
to be repeated after discharge from the
For an acute
attack you must go to the hospital immediately. In chronic
cases avoid alcohol and other things that aggravate your
- Intestinal Obstruction
- Acute pancreatitis
- Pancreatic Cancer
- Gallbladder infection or
- Mesenteric infarction - Sudden
interruption of blood flow to the bowels or intestine.
- Rupture or perforation of a stomach
- Penetrating stomach (peptic) ulcer.
- Aortic aneurysm - ballooning of the large blood vessel, the aorta.
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