$Unique_ID{BRK02192} $Pretitle{} $Title{An Explanation of Acute Pancreatitis} $Subject{Acute Pancreatitis inflammation pancreas gland bile ducts gallbladder trauma peptic ulcers blood calcium trypsin digestive enzymes ulcer-like nausea vomiting abdominal pain fever rapid heart rate bloated alcohol belly semi-conscious state laboratory tests imaging techniques amylase blood urine tripsinogen hemoglobin level leucocyte count blood sugar small bowel death white cell count BUN blood urea nitrogen serum calcium hematocrit enzymes cimetidine antacids Analgesics antibiotics oxygen Tube-feeding treatment} $Volume{} $Log{ Anatomy of the Pancreas*0016601.scf Diseases of the Pancreas*0016001.scf} Copyright (c) 1993 Tribune Media Services, Inc. An Explanation of Acute Pancreatitis ------------------------------------------------------------------------------ QUESTION: I need one of your special run downs about a disease. Your stuff is better than anything in the medical advisors that cost so much to purchase. Can you explain acute pancreatitis to me? As you might imagine, I and my family have a real need for this information. Thank you. ------------------------------------------------------------------------------ ANSWER: Thanks for that nice compliment. Acute pancreatitis is inflammation of the pancreas gland, most commonly resulting from heavy drinking or disease of the bile ducts or gallbladder. But it can also be the result of trauma, peptic ulcers or a high level of blood calcium. So there are many potential causes, and it is difficult to diagnose. The end result can be mild and self-limiting or severe and fatal, depending on the amount of cell damage that occurs. This in turn is reflected in the number of signs and symptoms present. In severe cases, digestive enzymes in the pancreas, such as trypsin, run amok and attack and destroy the cells of the gland itself. Like some other diseases, acute pancreatitis is a "great imitator," as clinical symptoms vary widely. But the most common are constant ulcer-like abdominal pain (worsened by eating and lessened by sitting upright), nausea and vomiting. Mild cases might produce only abdominal pain, while severe cases include fever, rapid heart rate, bloated belly, and even a semi-conscious state. Because it can appear under different disguises, the only sure-fire way to establish a diagnosis would be to examine the gland at operation. This is impractical and rarely done, unless bile duct obstruction exists. Instead, acute pancreatitis can be differentiated from other possible imitators by laboratory tests and imaging techniques. A high level of amylase in the blood or urine is one indicator that is highly sensitive but not specific. To firm up the diagnosis, tests for tripsinogen, hemoglobin level, leucocyte count, blood sugar and others are often needed. All this tests help the physician obtain a clearer idea of the exact nature of the disease state. In addition, x-rays might help reveal suspicious secondary changes in the small bowel associated with the disease. Ultrasound and CT scans are helpful in diagnosis and management. The outcome of acute pancreatitis is uncertain, and the chances of death increase for those over 55 years with a high white cell count, high blood sugar, high blood urea nitrogen (BUN), high serum calcium, high hematocrit, and high levels of various enzymes associated with destruction of the gland. The anti-ulcer drug, cimetidine, and antacids are used in treatment to decrease acids and prevent stress ulceration. Analgesics are used to reduce pain and prevent spasm of the gland. But each case must be diagnosed and treated individually, according to specific symptoms and life-styles. Tube-feeding might be required; heart complications might arise, so oxygen is often given; washing the abdominal cavity to remove toxic material might be necessary; antibiotics might be needed for associated infections. Since alcohol only worsens the disease, it should be strictly forbidden, and that may help prolong your life. With careful medical management the mortality from acute pancreatitis is slowly decreasing. Anticipating possible complications and the course of the illness seems to be the best course to follow at present. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.