The pancreas is a gland located in the abdomen near the stomach and duodenum and in the human body has two basic functions. Acute pancreatitis or acute pancreatic necrosis is a very serious disease, because despite very mild forms it may progress rapidly and result in the patient's death due to multiple organ failure. In addition, it can cause serious complications, which are long-term. Acute pancreatitis is one of the most serious acute diseases of the abdomen. This disease can be prevented by a healthy lifestyle.
Functions of pancreas
The pancreas is divided into two parts, exocrine and endocrine that perform two different functions. The cells of the endocrine part produce hormones important for maintaining stable blood sugar levels, called insulin and glucagon. Most pancreatic cells belong to the exocrine part that produces juice containing digestive enzymes, which digest food coming from the stomach into the small intestine. The juice from the pancreas gets to the small intestine by a thin duct, which before the outlet merges with the common bile duct, so the digestive juice flows into the small intestine together with the bile. It is very important for digestion of food, since digestive enzymes get into the gut in an inactive form and are activated by bile.
Causes of acute pancreatitis
There are a number of causes of acute pancreatitis. The most common cause are gallstones. They are formed in the gallbladder, from where they may descend to the bile duct and clog the common duct for bile and the pancreas. Bile is secreted into the bile duct all the time and it can get through the pancreatic duct into the pancreas and activate its digestive enzymes. The enzymes that normally break down food components begin to self-digest the pancreatic tissue and cause irreparable damage. Other causes of acute pancreatitis are one-time excessive alcohol intake or pancreatic injury in abdominal trauma, typically by the impact of handlebars in a bike accident. Also some other factors contribute to this disease, such as high levels of fat and calcium in the blood or certain drugs. In other cases, acute pancreatitis occurs due to an expanding peptic ulcer through the stomach wall into this area or mumps infection that attacks the salivary glands, testicles and sometimes the pancreas.
Symptoms of acute pancreatitis
Manifestations of acute pancreatitis can be very diverse. This disease is one of the most serious acute abdominal conditions and therefore it is necessary to recognize it as soon as possible. The classic symptom of acute pancreatitis is very severe abdominal pain around the navel, which may radiate to the back and is often accompanied by nausea and vomiting. Often is present fever without the presence of an etiological agent, or jaundice. In some cases, there is a strong reaction of the body, resulting in shock with lose of consciousness, cardiac arrest, and sometimes even death.
Complications of acute pancreatitis
Acute pancreatitis is a serious disease that can lead to local and systematic complications that worsen the patient's condition.
Local complications of acute pancreatitis include an abscess, a sac filled with pus and necrotic material. Also pseudocysts can occur, i.e. a sac, which forms several weeks after acute inflammation, and are filled with fluid and have a high content of enzymes. Also an infection of the pancreas can occur, or another repeated inflammation and tissue necrosis, leading to chronic pancreatitis.
Systemic complications of acute pancreatitis include diabetes, jaundice, low calcium levels, pneumonia or respiratory distress syndrome. Furthermore, the condition may be complicated by the development of decreased blood pressure, increased heart rate, including arrhythmias. It might even cause kidney failure, or to the development of disseminated intravascular coagulation, a life-threatening condition.
Diagnosis of acute pancreatitis
Diagnosis of acute pancreatitis is based on clinical, laboratory and imaging methods. For each patient, it is necessary to perform X-ray examination of the abdomen to rule out conditions of organ perforation. Furthermore it is necessary to perform abdominal ultrasonography, CT, or ERCP, endoscopic retrograde cholangiopancreatography. This is a method where a probe is introduced through the mouth into the duodenum to the pancreatic duct, and here the probe is inserted into the common bile duct, to examine the clogging of this path and thus find the cause this disease. Laboratory tests identify increased pancreatic enzymes, or the presence of bacteria.
Treatment of acute pancreatitis
Treatment of acute pancreatitis depends on the severity of the disease. Mild forms are usually not treated, the patient is only rehydrated and insufficient ions are administered. Also painkillers are administered, called analgesics. In serious cases, the patient should be hospitalized and closely monitored. Treatment of severe acute pancreatitis includes rehydration of the patient, treatment of pain, and the administration of artificial nutrition into the blood to prevent further production of pancreatic digestive juices which worsen the whole situation. In severe cases, surgical removal of the destroyed pancreatic tissue is performed. Even though there is a high risk of death.
Prevention of acute pancreatitis
Much better than treating acute pancreatitis, is its prevention. The first preventive measure is clearly an appropriate lifestyle comprising a mainly balanced and varied diet. Especially dangerous are one-time large dose of alcohol intake and fatty foods. It is recommended to not avoid any food, but consume all in reasonable amounts so our body can function properly as long as possible.