Acute Pancreatitis

Acute pancreatitis accounts for 3 to 5% of cases admitted in hospitals in emergency. It occurs due to acute inflammation of the pancreas. The pancreas is an abdominal organ situated adjacent to the bile producing gall bladder and transverse colon (horizontal part of large bowel lying in the upper abdomen). Pancreas produces enzymes which help in digestion of food. Insulin is produced in cells of part of pancreas which is responsible for maintaining glucose within normal levels in the body. The pancreas has a poor covering therefore it is inadequately shielded from adjacent body parts. It can easily be affected by inflammation in adjoining body parts. Vice versa, inflammation of pancreas can spread to the surrounding organs By far the most common cause of acute pancreatitis is alcohol. Other causes are few. Sometimes pancreatitis can occur in association with stones in the gall bladder and acute cholecystitis, i.e. inflammation of the gall bladder. Any surgery done or trauma in the pancreas or around can also lead to pancreatitis. Invasive investigative procedures done in the pancreas are yet another cause for pancreatitis. Certain medicines like tetracyclines, frusemide, non steroidal anti inflammatory drugs like Brufen, diclofenac, anti-epileptic drugs like sodium valproate, e.t.c. are known to cause pancreatitis as an adverse effect. Pancreatitis is also known to be caused by certain viral infections like mumps. High cholesterol levels in the blood are often associated with pancreatitis. Obesity is also a risk factor for developing this condition. Mild pancreatitis causes mild pain in the upper part of stomach radiating to the back. It can resolve without any treatment. Severe pancreatitis is characterized by excruciating pain in the abdomen. This pain is agonizing and slightly relieved by bending forwards. Often nausea and vomiting occur with severe pain. There may be associated fever particularly at the beginning. Complications can develop in some cases. There can be necrosis in the pancreatic tissue. Fluid can get collected in the pleural and peritoneal cavities (coverings of lungs and abdomen). Pancreatitis can lead to disturbances in the coagulation leading to bleeding below the skin layers as a complication. This can be seen as bluish discoloration around the umbilicus and thighs. Inflammation can spread to surrounding parts. Secondary infection can occur in the affected part leading to multiple abscesses. All these complications need urgent treatment otherwise it can be fatal. If the risk factors persist, an individual can get repeated episodes of pancreatitis. These repeated episodes can cause chronic pancreatitis, where the person chronically suffers from pain. Diabetes can be precipitated or aggravated by pancreatitis. Typical clinical features and history of alcohol intake often point to the diagnosis of acute pancreatitis. High levels of enzyme amylase in the blood confirm the diagnosis. Ultrasound and other imaging techniques are used to confirm the diagnosis. It has to be differentiated from other problems causing severe abdominal pain like cholecystitis, intestinal colic, e.t.c. The patient is hospitalized in emergency and the gastric contents are evacuated by means of a tube put in the nasal cavity. Nothing is allowed by mouth till the pain subsides to give rest to the bowels and hence the pancreas because pancreatic enzymes aid in digestion. Intravenous perfusions are given to maintain the vital signs of the patient. Analgesics or pain killer drugs are given to relieve the pain. Antibiotics are necessary to prevent and treat any infection if it develops. Complications are often treated surgically. As such nobody can predict what can happen inside a human body. But certain problems can be prevented. Acute pancreatitis is one of them. Avoidance of alcohol is one of the most important measures to avoid pancreatitis. Regular exercise and intake of low fat diet is useful to prevent obesity and also pancreatitis. –rachna212002@yahoo.co.uk