Acute Pancreatitis

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Pancreas
The pancreas is a large gland located behind the stomach and close to the upper part of the small intestine.
Secretes digestive enzymes into the small intestine through a tube is called the pancreatic duct. These enzymes help digest the fats, proteins and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it derives from food for energy.

Acute Pancreatitis
Acute pancreatitis is an inflammation of the pancreas.
Signs and Symptoms:
Acute pancreatitis usually begins with a sharp, severe pain in the upper abdomen that may last for a few hours or a few days.
Symptoms include:
1- Constant pain in the upper abdomen, in the back and other areas
2- Pain may be sudden and intense or may begin as a mild pain that is aggravated by eating and drinking
3- Elevated pulse
4- Fever
5- Nausea and vomiting
6- Swollen and tender abdomen
Diagnosis:
Your doctor will ask about your medical history, perform a physical exam and order blood tests to check for certain enzymes.
During acute attacks, the blood contains at least three times more than the normal amount of digestive enzymes formed in the pancreas. Changes may occur in blood levels of glucose, calcium, magnesium, sodium, potassium and bicarbonate. After the pancreas recovers, these levels usually return to normal.
An abdominal ultrasound to look for gallstones and a computerized tomography (CT) scan to check for injury to the pancreas may be performed.
A procedure, called an endoscopic retrograde Cholangiopancreatography (ERCP), may determine if there is a bile duct obstruction. During this procedure, a flexible tube is inserted down the throat into the stomach and small intestines. Dye is injected into the drainage tube of the pancreas to locate a possible obstruction.

Treatment:
Treatment for acute pancreatitis depends on the severity of the attack. Many cases get better with time, unless complications develop. Usually, patients are hospitalized to receive intravenous fluids to restore blood volume and hydration as well as medications to control pain. Antibiotics may be given if an infection occurs.
Dietary guidelines are usually prescribed to reduce the fat you eat, since your body has trouble digesting these substances.
Surgery
Surgery may be needed if complications such as infection, cysts or bleeding occur. If gallstones are the cause of your attack, the gallbladder may be removed.
If a bile duct obstruction is suspected of causing the pancreatitis, a procedure called an endoscopic retrograde cholangiopancreatography (ERCP) may be performed. A flexible tube is inserted down the throat into the stomach and small intestines. Dye is injected into the drainage tube of the pancreas to locate the possible obstruction. Special instruments are inserted through the endoscope or tube to remove the obstruction or stretch a narrowing segment of the bile duct.

Patients with severe acute pancreatitis may develop pancreatic necrosis, a serious infection in which tissue within the pancreas dies and later becomes infected. This result in a condition called acute necrotizing pancreatitis. An abscess may form on the dead tissue several weeks after an attack of acute necrotizing pancreatitis.

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