Pancreatitis
Inflammation of the pancreas with acute and chronic forms.
Pancreatitis happens when the pancreas becomes inflamed. This large organ sits behind the stomach and makes digestive enzymes and several hormones. The condition comes in two forms: acute and chronic. Acute pancreatitis was first described in detail by Reginald Fitz in 1889, building on earlier accounts from autopsies, while chronic pancreatitis was recognized as early as the 19th century, with notable descriptions by Friedrich Daniel von Recklinghausen.
The main symptoms include severe upper abdominal pain that often radiates to the back, along with nausea and vomiting. Eating usually makes the pain worse. In acute cases, a fever may appear, and symptoms typically clear up within a few days. Chronic pancreatitis can lead to weight loss, fatty stools, and diarrhea. Physical signs vary depending on severity and internal bleeding. Blood pressure may be high from pain or low from dehydration or blood loss. Heart and breathing rates often rise. The abdomen feels tender, though less so than the pain itself. Bowel sounds may decrease due to reflex paralysis of the gut. Fever or jaundice can occur. Chronic pancreatitis also raises the risk of diabetes and pancreatic cancer.
Early complications include shock, infection, systemic inflammatory response syndrome, low blood calcium, high blood glucose, and dehydration. Blood loss, dehydration, and fluid leaking into the abdominal cavity (ascites) can cause kidney failure. Respiratory issues are often severe, with pleural effusion common. Shallow breathing from pain may lead to lung collapse, and pancreatic enzymes can attack the lungs, causing inflammation. Severe inflammation can increase pressure inside the abdomen (intra-abdominal hypertension) and lead to abdominal compartment syndrome, which may require an open abdomen to relieve pressure. Later complications include recurrent pancreatitis and pancreatic pseudocysts—collections of pancreatic secretions walled off by scar tissue. These can cause pain, become infected, rupture, bleed, block the bile duct (causing jaundice), or move around the abdomen. Acute necrotizing pancreatitis can result in a pancreatic abscess—a pus collection from necrosis, liquefaction, and infection—occurring in about 3% of cases, or nearly 60% of cases with more than two pseudocysts and gas in the pancreas.
About 80% of pancreatitis cases are caused by gallstones or alcohol.
Quick Facts
- Field
- Gastroenterology · general surgery
- Symptoms
- Pain in the upper abdomen · nausea · vomiting · fever · fatty stool
- Complications
- Infection, bleeding, diabetes mellitus, pancreatic cancer, kidney failure, breathing problems, malnutrition
- Duration
- Short or long term
- Causes
- Gallstone · heavy alcohol use · direct trauma · certain medications · mumps
- Risks
- Smoking
- Diagnosis
- Based on symptoms, blood amylase or lipase
- Treatment
- Intravenous fluids, pain medication, antibiotics
- Frequency
- 8.9 million (2015)
- Deaths
- 132,700 (2015)
Facts from the source article.
Lore & Background
Signs and symptoms of pancreatitis include severe upper abdominal pain radiating to the back, nausea, and vomiting. In acute pancreatitis, a fever may occur and symptoms typically resolve in a few days. In chronic pancreatitis, weight loss, fatty stool, and diarrhea may occur. Complications may include infection, bleeding, diabetes mellitus, or problems with other organs. The two most common causes of acute pancreatitis are a gallstone blocking the common bile duct and heavy alcohol use. Chronic pancreatitis is most commonly due to many years of heavy alcohol use. Smoking increases the risk of both types.
Reader's Guide
Pancreatitis is a significant medical condition due to its potential severity and complications. Acute pancreatitis is usually treated with intravenous fluids, pain medication, and sometimes antibiotics. In severe cases, a nasogastric tube may be placed, and an endoscopic retrograde cholangiopancreatography (ERCP) may be performed to remove a gallstone. Chronic pancreatitis may require long-term dietary changes and pancreatic enzyme replacement, and occasionally surgery to remove parts of the pancreas. Globally, in 2015, about 8.9 million cases occurred, resulting in 132,700 deaths. The condition is more common in men, and chronic pancreatitis often starts between ages 30 and 40. Diagnosis of acute pancreatitis is based on a threefold increase in blood amylase or lipase; in chronic pancreatitis, these tests may be normal. Medical imaging such as ultrasound and CT scan are also useful.
More in Inflammatory diseases of the digestive system 1-22
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced