Acute pancreatitis

• abdominal trauma
• cystic fibrosis
• hemolytic uremic syndrome
• Kawasaki disease
• mumps
• Reye's syndrome
• various viral illnesses

Prevention:
Prevention of acute pancreatitis is associated with prevention of the causative disorders.

If you drink alcohol, control alcohol intake.

Use proper safety precautions to avoid abdominal trauma.

Genetic counseling may be advised for prospective parents with a family or personal history of cystic fibrosis .

Cook meat thoroughly (this is one way to reduce the risk of hemolytic uremic syndrome ).

To reduce the risk of Reye's syndrome , avoid aspirin for treatment of fever in children, especially if they may have a viral illness.

Immunize children against mumps and other childhood illnesses (see Immunizations - general overview ).

Symptoms:

• abdominal pain that is greatest in the upper abdomen (upper right quadrant or upper middle of the abdomen)
  • persistent or chronic
  • recurrent or with similar pain in past
  • may be worse lying flat on the back (supine)
  • may radiate to the back or below the right shoulder blade (right scapular area)
  • pain radiating through to the middle of the back
  • may be worse by eating or drinking (occurs within minutes following meals), especially greasy foods or foods with a high fat content
  • pain may be worse after drinking alcohol

• nausea
• vomiting
• weakness
• sweating
• anxiety
• fever
• skin, clammy
• mild jaundice

Additional symptoms that may be associated with this disease:

• abdomen, swollen
• abdominal fullness, gaseous
• abdominal indigestion
• bruising or bleeding into the skin
• chest pain under the breastbone
• flank pain
• gas/flatus, excessive
• hiccups
• skin rash or lesion
• stools, clay colored

Signs and Tests:
General examination may show a low blood pressure and a heart rate above 90 (this is slightly rapid).

Tests that show release of pancreatic enzymes:

• elevated serum amylase
• elevated urine amylase
• elevated serum lipase

Test that show inflammation of the pancreas:

• abdominal CT scan
• abdominal ultrasound

In other blood tests results:

• A CBC shows an elevated WBC count .
• A glucose test may be elevated.
• Serum calcium may be decreased.

This disease may also alter the results of the following tests:

• trypsinogen
• serum magnesium - test
• LDH isoenzymes
• LDH
• fecal fat
• CEA
• calcium (ionized)
• AST

Treatment:
Treatment is aimed at supportive measures such as fluid replacement by intravenous (IV) infusion, pain relief by analgesics , and withholding food or fluid by mouth to restrict pancreatic activity that makes symptoms worse. Occasionally nasogastric suctioning may be required if there is persistent vomiting , severe pain, or a paralytic ileus develops.

Recurrence of the attack may be prevented by treating the underlying condition.

Surgery or endoscopic therapy (using an endoscope, a device with a light that can look inside a body cavity) is indicated in some cases to remove gallstones blocking the drainage of the pancreas. In severe cases, the pancreas may be removed.

Prognosis:
In most cases, the symptoms resolve in a week; however, in some cases, life-threatening illness develops. The death rate is high with hemorrhagic pancreatitis when complications such as liver, heart, or kidney impairment are present. Recurrences are common.

Complications:

• low blood pressure
• heart failure
• kidney failure
• ARDS (adult respiratory distress syndrome)
• ascites , accumulation of fluid in the abdomen
• cysts or abscesses in the pancreas

Call Your Healthcare Provider:
Call your health care provider if intense, constant abdominal pain is present, or if other symptoms that are suggestive of acute pancreatitis develop.


This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.