ACUTE PANCREATIT...

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Digestive system

Endocrine glands

Pancreatitis, acute...

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Definition

Acute pancreatitis is swelling (inflammation) of the pancreas. The pancreas is a gland located behind the stomach. It releases digestive enzymes and the hormones insulin and glucagon.

Causes, incidence, and risk factors

The main causes of acute pancreatitis in adults are:

• Alcohol use
• Gallbladder (biliary) disease
• Gallstones

Other causes include:

• Certain medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine)
• Common bile duct surgical procedures
• Surgery to the pancreas
• Traumatic injury
• Viral infection (mumps, coxsackie B, mycoplasma pneumonia, and campylobacter)

Acute pancreatitis may also be caused by:

• An abnormal structure of the pancreas
• Complications of cystic fibrosis
• Genetic factors (hereditary pancreatitis)
• High lipid levels in the blood (hypertriglyceridemia)

What exactly causes pancreatitis is not well known. It is thought that enzymes the pancreas normally releases in an inactive form become activated inside the pancreas and start to digest the pancreatic tissue. This process is called autodigestion. It causes swelling, bleeding (hemorrhage), and damage to the blood vessels.

The disease affects men more often than women. Alcohol abuse is an important risk factor.

In children, this disorder may be associated with:

• Abdominal trauma
• Cystic fibrosis
• Hemolytic uremic syndrome
• Kawasaki disease
• Mumps
• Reye syndrome
• Some medications
• Various viral illnesses

Symptoms

• Abdominal pain that is greatest in the upper abdomen (upper left quadrant or upper middle of the abdomen)
  • Is persistent or chronic
  • May be worse lying flat on the back
  • May spread (radiate) to the back or below the left shoulder blade
  • May be worse after eating or drinking (occurs within minutes following meals), especially foods with a high fat content
  • May be worse after drinking alcohol
• Anxiety
• Fever
• Mild jaundice
• Nausea and vomiting
• Sweating

Other symptoms that may occur with this disease:

• Indigestion
• Clay-colored stools
• Gaseous abdominal fullness
• Hiccups
• Skin rash or lesion
• Swollen abdomen

Reviewer Info: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 05/27/2008