Pancreatitis

Pancreatitis is inflammation of the pancreas. The most common causes of acute pancreatitis are gallstones and excessive consumption of alcohol. Less common causes include hypertriglyceridemia and only when triglyceride values exceed 1500 mg/dl, hypercalcemia, viral infection, trauma including post-ERCP, vasculitis, and autoimmune pancreatitis. Pregnancy can also cause pancreatitis, but in some cases the development of pancreatitis is probably just a reflection of the hypertriglyceridemia which often occurs in pregnant women. Pancreas divisum, a common congenital malformation of the pancreas may underlie some cases of recurrent pancreatitis.

Severe upper abdominal pain, with radiation through to the back, is the hallmark of pancreatitis. Traditionally it is stated that the pain of pancreatitis is relieved by bending forward. Nausea and vomiting are prominent symptoms. Findings on the physical exam will vary according to the severity of the pancreatitis, and whether or not it is associated with significant internal bleeding. The blood pressure may be high or low. Typically, both the heart and respiratory rates are elevated. Often, in more severe cases, there is evidence of a pleural effusion. Abdominal tenderness is usually found but may be less severe than expected given the patient's degree of abdominal pain. Bowel sounds may be reduced as a reflection of the reflex bowel paralysis that may accompany any abdominal catastrophe. If there has been severe internal bleeding, the skin around the umbilicus or the flanks may be discolored with a dark reddish or purple hue. The discoloration is blood which has tracked along the retroperitoneal fascial plane.

The treatment of pancreatitis will, of course, depend on the severity of the pancreatitis itself. Still, general principles apply and include 1. provision of pain relief, 2. provision of adequate replacement fluids and salts, 3. limitation of oral intake, and 4. monitoring and assessment for, and treatment of, the various complications listed above. When necrotizing pancreatitis ensues and the patient shows signs of infection it is imperative to start antibiotics such as Imipenem due to its high penetration of the drug in the pancreas.

...More at Wikipedia

Related Links:

• US National Library of Medicine
• Mayo Clinic

Recent Hope Cube Blog Entries For Pancreatitis

• My Pancreas Tue, November 27, 2007 - [view]
  Three years ago, I felt sharp jabbing pains in my side. I was nautious and couldn't keep food down. As a diabetc, this was particularly worrisome. After 12 hours of pain and suffering, my mom took me to the Emergency Room. I was 27. When we got there, I was immediately admitted wit hsevere pancreatitus. Reported to be one of the most painful diseases, I had a severe case. By the time I made it to the hospital room, my liver, kidneys, and pancreas had all shut down. For the next 3 weeks, I was kept on a steady diet of pain medication--and that's it. I wasn't allowed to eat (I was fed intraveniously). When they finally released me fro mthe hospital, I had lost 40 pounds. But my ordeal wasn't over. I had missed a month of work and wasn't cleared to return for another 2 ...