Pancreatitis is an inflammation of the pancreas, a large gland located behind the stomach and close to the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest the fats, proteins and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it derives from food for energy.
When the pancreas becomes inflamed, the digestive enzymes attack the tissue that produces them. This can lead to tissue damage and bleeding as well as causing the pancreas blood cells and blood vessels to swell.
Pancreatitis has two stages — acute and chronic. Most cases of acute pancreatitis are mild and involve a short hospital stay for the pancreas to recover completely. Chronic pancreatitis is a much more persistent condition that occurs more often in men than women. This condition may increase your chances for developing pancreatic cancer.
Acute pancreatitis affects about 80,000 Americans annually and occurs suddenly after the pancreas is damaged. Some patients may have more than one attack, but typically recover after each one. About 20 percent of cases are severe, leading to heart, lung or kidney failure. In the most severe cases, bleeding can occur in the pancreas, resulting in shock and sometimes death. Although the cause of the condition is sometimes unknown, it usually results from gallstones or alcohol abuse. Other less common causes of this condition include excessive levels of fat particles in the blood, mumps, drugs and surgery. In addition, pancreatitis can be heredity.
Acute pancreatitis usually begins with a sharp, severe pain in the upper abdomen that may last for a few days. It may be constant pain that is just in the abdomen or it may reach to the back and other areas. The pain may be sudden and intense or it may begin as a mild pain that is aggravated by eating and slowly gets worse. In addition, the abdomen may be swollen and very tender. Other symptoms may include nausea, vomiting, fever and an elevated pulse.
Your doctor will ask about your medical history, perform a physical exam and order a blood test that checks for certain enzymes. During acute attacks, the blood contains at least three times more than the normal amount of the digestive enzymes formed in the pancreas. Changes also may occur in blood levels of glucose, calcium, magnesium, sodium, potassium and bicarbonate. After the pancreas improves, these levels usually return to normal.
In addition, your doctor may recommend that you have an abdominal ultrasound to look for gallstones and a computerized tomography (CT) scan to check for injury to the pancreas.
Treatment for acute pancreatitis depends on the severity of the attack. Acute pancreatitis usually gets better by itself, unless complications develop. Usually patients spend time in the hospital receiving intravenous fluids that help restore blood volume and hydration, as well as medications and certain enzymes to control pain.
Antibiotics may be given if signs of infection arise. Surgery may be needed if complications such as infection, cysts or bleeding occur. If gallstones were the cause of your attack, removal of the gallbladder or surgery of the bile duct may be required. A procedure known as endoscopic retrograde cholangiopancreatography (ERCP) also may relieve bile duct obstruction. During this procedure, a flexible tube is inserted down the throat into the stomach and small intestines. By injecting dye into the drainage tube of the pancreas, your doctor can see the area more clearly. Surgery to remove dead tissue on the pancreas also may be recommended.
Reviewed by health care specialists at UCSF Medical Center.
Last updated
December 21, 2011
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