Acute Pancreatitis

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Acute pancreatitis is a serious medical condition whereby there is inflammation of the pancreas over a short period of time. The pancreas is an organ located in the abdomen that is surrounded by the stomach and small intestines. Its function is to produce pancreatic juices that are helpful in digestion of food, and it also produces a hormone called insulin that regulates blood sugar. There are several causes of this condition and its important to recognise it early and treat it appropriately.

The most common symptom of this condition is usually abdominal pain. This pain is usually located in the right upper abdomen but can be central and spread to the back. The pain often starts suddenly and can start off being sharp in nature and eventually becomes dull and constant. This is often associated with nausea and vomiting. Some individuals may also have diarrhoea as a symptom.

Depending on the severity of the condition, they may be fever and a fast heartbeat. Some individuals develop very low blood pressures which can lead to hemodynamic instability and circulatory collapse. As the condition worsens, they may be shortness of breath and some fluid accumulation in the lungs.

The commonest causes of pancreatitis are gallstones, which I discussed in detail in last week’s column and alcohol. When a gall stone gets trapped in the bile or pancreatic ducts it results in poor flow of pancreatic juices and results in the pancreas digesting itself. An alcohol binge can also result in the development of acute pancreatitis.

Other less common causes include trauma to the pancreas as well as post invasive procedures of the pancreas. Infections such as mumps are also known to causes pancreatitis. Certain medications such as corticosteroids and sodium valproate which is used to treat epilepsy have also been implicated. Very high calcium and high triglycerides in the blood are also know causes of pancreatitis. Rare causes include scorpion bites.

This diagnosis is usually made by doing several blood tests that look at whether there is inflammation of the pancreas or not. Other blood tests are also done in order to assess the severity of the condition. In addition to this an ultrasound scan is done initially to assess the pancreas as well as to look for gall stones. In certain cases, especially when the condition is severe, a CT scan of the pancreas is required.

The treatment of this condition depends on the cause. Some of the cornerstones of management include aggressive fluid support, nutritional support and in certain cases antibiotics if there is evidence of infection or necrosis. In some cases, it may be necessary to do surgery, for instance when there are gall stones, severe necrosis or even blockage of the pancreatic duct.

Early recognition and treatment of this condition can be lifesaving. Its important to contact health care workers when there is a suspicion of the condition.

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