Acute pancreatitis is a condition resulting from inflammation of the pancreas. The main function of the pancreas is to produce digestive enzymes, insulin and glucagon that regulate blood sugar levels.
In pancreatitis, pancreatic enzymes that are normally released in the small intestines to aid digestion are activated inside the pancreas and start to damage it. If the crisis is severe or prolonged, or if outbreaks of acute pancreatitis occur repeatedly, permanent damage to the pancreas can occur and lead to a condition called chronic pancreatitis.
The two most common causes of pancreatitis are gallstones and bile alcoholism (alcohol abuse). As the pancreatic duct, which carries digestive enzymes from the pancreas into the small intestine is the common bile duct, which comes from the gallbladder and liver, gallstones that clog the channel prevent pancreatic enzymes from reaching the intestines, being accumulated inside the liver and it is activated by eroding the body inside. Although most people who drink alcohol do not develop pancreatitis, drinking large amounts of alcohol can activate pancreatitis.
Other factors that sometimes can cause pancreatitis include:
Abdominal trauma (traumatic pancreatitis)
Abdominal surgery, drugs, including certain antibiotics (metronidazole, tetracycline and sulfa drugs), thiazide diuretics and estrogen, calcium or High levels of triglycerides in the blood, some infections such as mumps or viral hepatitis,
Endoscopic procedures involving the bile duct and pancreatic
Idiopathic (no cause is found).
Symptoms
Symptoms of acute pancreatitis include:
the upper abdominal pain that may be tolerable to the stabbing, in a band at the time of the stomach, both right and left;
Projection of the pain to the back, chest, flank or down
Worsening of the pain with food, especially fatty
nausea and vomiting,
o Loss of appetite,
the abdominal distention (swelling),
The Fever,
o Lack of air,
Fatigue,
Hypotension and the shock (very low pressure, disabling the functioning of organs).
Diagnosis
The patient's history will reveal the abuse of alcohol which, when absent, especially in women, is strongly suggestive of gallbladder calculi, confirmed by ultrasound examination.
Blood tests reveal elevated levels of pancreatic enzymes, amylase and lipase confirm the diagnosis of pancreatitis. The decrease of calcium in the blood is a sign of worsening, as well as the increase of leukocytes, glucose, urea and creatinine.
In some cases of pancreatitis, blood amylase may be normal as it rises rapidly at first and then decreases, does not mean improvement.
In some cases, computed tomography is suspected when swelling of the pancreas and the presence of fluid in the abdomen. CT scans also can reveal pancreatic pseudocysts are well containing pancreatic enzymes that develop in some cases of severe pancreatitis in chronic pancreatitis. Serious complications can occur when the cysts burst and enzymes come in contact the surface of the abdomen (peritonitis).
Prevention
Avoid the abuse of alcohol if the person never had pancreatitis,
Never drink the more, if the person has had one episode of alcohol-induced pancreatitis,
It is believed that to maintain a normal weight and avoiding rapid weight loss can prevent the development of gallstones,
Avoid the indiscriminate use of antibiotics and oral contraceptives the basis of estrogen.
Treatment
· General:
Rest in hospital
Fasting to "rest" the pancreas,
the replacement fluid intravenously
the passage of a nasal tube into the stomach to control the vomiting, the parenteral nutrition (through a vein thick) may be required in severe cases,· Medications to protect stomach stress ulcers. Include H2 blockers (ranitidine hydrochloride) and proton pump inhibitors (omeprazole, pantoprazole, esomeprazole, etc.)
· Antibiotics are only indicated in severe cases and when the cause is gallstones by the frequent presence of infection of the gallbladder - cholecystitis.
• The Surgery is indicated in the following situations:
The definitive treatment of gallstones (cholecystectomy)
Infection with the documented pancreatic abscess (collection of pus)
the necrosis (deterioration) of the pancreas extensive,
the major bleeding,
Shock that does not improve
the failure of multiple organs.
What Is It?
The patient with severe abdominal pain, does not improve with the portion sizes, or is accompanied by intense nausea or vomiting, you should seek a surgeon general or treated at an emergency room.
Prognosis.
Pancreatitis often improves slightly in the first week, without complications and without any further problem, but severe cases can last several weeks. Chronic pancreatitis may develop if there is a significant injury to the pancreas or if the patient had several attacks over time.
Nearly 10 percent of patients develop complications such as abscesses and necrosis of the pancreas that may require surgical treatment.
The pancreatitis caused by alcohol in crises occur from time to time, if the patient insists on drinking. Approximately 10 percent of patients with acute pancreatitis develop alcohol-related chronic pancreatitis.
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