What is Acute pancreatitis?
Acute pancreatitis refers to inflammation of the pancreas. It is painful, suddenly developing pancreatitis and in some cases it can be life-threatening.
A few mild cases can be resolved without treatment, but serious acute pancreatitis can trigger all possible life-threatening complications. The mortality ratio is somewhere in between less than 5 percent to over 30 percent, according to the seriousness of the disease and whether it affected other organs outside the pancreas.
Acute pancreatitis is about affecting in between 4.5 and 35 in every 100,000 persons each year. However, these data may not include the large number of mild cases that provide relief without medical evaluation or treatment. There are 275,000 hospitalizations due to acute pancreatitis in the USA per year.
The pancreas is an elongated flat gland located behind the stomach in the upper abdominal region. It generates digestive enzymes and hormones that regulate precessing glucose in the body. such as insulin.
The most common cause of pancreatitis is gallstones, but excessive alcohol consumption is also associated with an increase. Alcohol is currently considered for approximately 30 percent of cases.
Acute pancreatitis begins early, but chronic pancreatitis is repeatable or continuous. The focus in this article is acute pancreatitis.
The patient will quickly feel pain at the centre of the upper abdomen, under the sternum or sternum.
Rarely, pain initially occurs in the lower part of the abdomen. It will slowly increase in intensity and eventually turn into constant pain.
The pain can increase even more and become severe. It also spreads through the back in approximately half the cases. Eating can be more painful.
Pancreatitis from gallstones occurs very quickly. When it is caused by alcohol, the symptoms appear slower, and can take many days.
Leaning forward or being in a fetal position (bending) can help reduce the pain slightly. Anyone who suffers from constant pain should consult a doctor.
Other symptoms include the following:
- loss of appetite
- Increased pulse
- cough with pain, powerful movements and deep breathing.
- tenderness at the touch of the abdomen.
- fever with minimal temperature of 100.4 °F (38 °C) atleast
- jaundice, when the skin and sclerosis in the eyes become yellow.
- Pain can’t be relieved even with heavy painkillers.
- fluctuations in blood pressure (may fall or rise) but will fall when patient is standing sometimes leading to fainting.
Treating acute pancreatitis will depend on its intensity. In mild cases, the risk of complications is smaller, whereas in severe cases, the risk is significant.
Treatment for mild acute pancreatitis
The purpose of the treatment is to maintain body functions and relieve symptoms while the pancreas repairs itself.
- Painkillers: Mild acute pancreatitis may cause little to very pain.
- Nasogastric tubes: A tube can remove additional fluids and air to treat nausea and vomiting.
- Bowel rest: The digestive system will not need to function for a few days, to prevent the person from taking food or drink orally until the condition improves.
- Preventing dehydration: Dehydration frequently follows pancreatitis and may make symptoms and complications worse. The fluid is usually administered intravenously for the first 24 to 48 hours.
The person is usually able to leave the hospital after five to seven days.
Treatment for severe acute pancreatitis
Severe acute pancreatitis usually leads to certain tissue death or necrosis. It increases the risk of sepsis (a serious bacterial infection which can affect the whole body). Sepsis can be life-threatening and can lead to multiple organ damage or failure.
Severe acute pancreatitis may also be associated with hypovolemic shock. A serious loss of blood and fluid can render the heart incapable of pumping the blood needed for the body. The body’s organs and tissues can quickly lose oxygen. This is a life-threatening condition.
Treatment of this type of pancreatitis includes:
- Treatment in the intensive care unit (ICU): Antibiotic injections aim at preventing the development of an infection in dead tissue.
- Intravenous fluids: They help to maintain hydration in order to prevent hypovolemic shock.
- Breathing assistance: The ventilating equipment will assist the patient to breathe.
- Feeding tubes: They supply adequate nutrition. In such a case, early nutrition improves the results.
- Surgery: In some cases, a surgical procedure may be necessary to remove dead tissue.
The patient will be maintained in intensive care until he is no longer at risk of organ insufficiency, hypovolemic shock and sepsis.
In the case of acute pancreatitis caused by gallstones, Surgery or endoscopic retrograde cholangiopancreatography (ERCP) may occur after the patient’s condition improves.
After removing gallstones, the patient may be advised to follow a special diet to lower blood cholesterol, because high cholesterol increases the growth of gallstones.
The American Gastroenterological Association suggests a surgical procedure to remove the gall bladder from any patient who develops pancreatitis caused by gallstones.
Gallstones, infections and alcoholism are common reasons for acute pancreatitis.
Those who have been drinking for many years may develop pancreatitis. Increased alcohol intake is associated with an increase in the risk of chronic pancreatitis.
Trypsin is an enzyme released into the pancreas in its inactive form.
Excess alcohol consumption may cause trypsin to activate while still in the pancreas, but scientists are unsure of its real cause.
Scientists believe that ethanol molecules trigger pancreatic cells when trypsin is activated prematurely.
Gallstones are tiny stone formations that form in the gall bladder, in general, if there is too much cholesterol in the bile.
Sometimes, gallstones can block the hepatopancreatic canal or pancreatic canal as they burrow out of the bile ducts and into the gut.
This obstruction will also affect the pancreas and prevent it from releasing its enzymes in the intestinal tract.
In the case of acute pancreatitis associated with gallstones, cholecystectomy (removal of the gallbladder) is usually suggested before the patient’s departure from hospital.
The following bacterial infections may cause acute pancreatitis: Salmonellosis, some form of food poisoning due to Salmonella bacteria, or Legionnaires’ disease, an infection due to the bacteria Legionella pneumophila located in plumbing, showerheads and water storage tanks.
Acute pancreatitis may also be caused by some viruses, like the hepatitis B virus, mumps virus coxsackievirus, cytomegalovirus, and varicella-zoster virus.
Other likely causes include:
- certain autoimmune disorders, like. lupus, or Sjogren’s syndrome
- genetic mutations which make certain individuals more sensitive.
- pancreatic injuries
- Higher levels of triglycerides in the blood.
- increased levels of calcium in your blood.
Over 10 percent of all cases of acute pancreatitis are referred to as idiopathics, which means that there is no clear cause.
As far as most people with acute pancreatitis are concerned, there are no dietary restrictions, but the person may not be able to eat for a few days, or they are not required to take solid foods.
There are people in the hospital who may need a feeding tube.
Once the person starts eating again, they will probably advised to follow a diet that is healthy and low in fat, and eat small amounts at regular intervals.
It is important that you drink plenty of fluids, but avoid caffeine and alcoholic beverages.
The United States food guidelines offer advice to have a healthy nutrition, low in fat.
Pancreatitis has the potential to cause life-threatening complications.
- Obstruction of the biliary or pancreatic pathway.
- pancreatic duct leak.
- pseudocysts, risk of rupture, haemorrhage and infection.
- damage in pancreatic cells.
- pleural effusion
- splenic vein thrombosis
Organs such as the heart, lungs and kidneys may be deficient. In serious cases, organ failure may occur approximately 48 hours after symptoms appear. They can kill you if they’re not treated. It is important that you get treatment right away if you have signs of acute pancreatitis.
The physician will interview the patient for symptoms and examine the abdomen. If there are areas in the abdomen that are sensitive to contact, this could indicate acute pancreatitis.
If you have acute pancreatitis, the abdominal wall muscles will be hard. Listening to the abdominal sound with a stethoscope can result in very low or no bowel sounds.
If the amylase and lipase blood levels are higher than usual, the patient may be hospitalized. The pancreas results in increased levels of the two enzymes during acute pancreatitis.
However, blood tests may not be exact if they are not sampled on the first or second day of the disease. This is because the levels of lipase and amylase are highest in the early hours and back at a normal level after a few days.
Amylase comes back to normal in 3 to 7 days, and lipase comes back to normal in about 8 to 14 days.
Further testing in hospital
To find out if there are any complications, a physician will want to measure the severity of pancreatic inflammation, the following tests are possible:
- ERCP (endoscopic retrograde cholangiopancreatography) scan: An endoscope (thin and flexible tube with camera attached to the end) is inserted into the GIT. A ERCP can help determine the correct location of a bile stone.
- An ultrasound scan: High-frequency sound waves create an image of the pancreas, gall bladder and the surrounding environment on the screen.
- CECT (contrast-enhanced computed tomography) scan: These are used to capture images from the same area from different angles, which are then combined to produce a 3D image. CECT scans can help identify pancreatic inflammation, fluid collection, and any changes to pancreatic density.
- Chest X-ray: The physician may suggest a chest x-ray to determine areas of collapsed lung tissue, or fluid build-up in the chest cavity.
Acute pancreatitis is usually completed in a few days with the right treatment, however, some individuals may be required to remain in hospital for a period of time,