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Acute Pancreatitis - Overview (signs and symptoms, pathophysiology, investigations, treatment)Pancreas diseases -
Endocrine tissue secretes substances into the bloodstream. These grape-like cell clusters produce important hormones that regulate pancreatic secretions and control blood sugar. A healthy pancreas produces chemicals to digest the food we eat.
The exocrine tissues secrete a clear, watery, alkaline juice into the common bile duct and, ultimately, the duodenum. This substance contains several enzymes that break down food into small molecules.
The intestines can then absorb these smaller molecules. The endocrine tissue secretes insulin and other hormones into the bloodstream. Pancreatic beta cells release insulin when blood sugar levels rise.
Insulin moves glucose from the blood into muscles and other tissues for use as energy. Insulin also helps the liver absorb glucose, storing it as glycogen in case the body needs energy during stress or exercise. When blood sugar falls, pancreatic alpha cells release the hormone glucagon.
Glucagon triggers the breakdown of glycogen into glucose in the liver. The glucose then enters the bloodstream, restoring blood sugar levels to normal. If the pancreas does not produce enough digestive enzymes, for example, the digestive system will not absorb nutrients as intended.
This can lead to weight loss and diarrhea. Additionally, too little insulin production will increase the risk of diabetes, and blood glucose levels will rise. Pancreatitis refers to an acute or chronic inflammation of the pancreas.
It can lead to secondary diabetes. Inflammation can occur if gallstones or tumors block the main duct from the pancreas. Pancreatic juices will accumulate in the pancreas, causing damage.
The pancreas may start to digest itself. Pancreatitis can happen as a result of mumps, gallstones, trauma, and the use of alcohol, steroids, and drugs. Acute pancreatitis is the sudden, rapid inflammation of the organ. The condition is rare , but it needs immediate medical attention.
Immediate treatment is normally with fluids and painkillers. If a secondary infection occurs, surgery may be necessary. Chronic pancreatitis can develop if acute pancreatitis repeatedly happens, resulting in permanent damage.
The most common cause is alcohol abuse, and it mostly affects middle-aged men. Learn the differences between acute and chronic pancreatitis here. A person may experience pancreatitis due to inheriting misfunctioning PRSS1 and SPINK1 genes.
It is a progressive condition that can lead to permanent damage. The person may experience pain, diarrhea, malnutrition , or diabetes. Treatment aims to control pain to replace lost enzymes. Cancer can develop in the pancreas. The exact cause is often unknown, but risk factors for pancreatic cancer include:.
Pancreatic cancer symptoms may not appear until the cancer is in the advanced stages. By then, it may be too late for successful treatment. The outlook for pancreatic cancer tends to be poor.
Treatment usually involves surgery, chemotherapy , radiation, or a combination. Palliative treatment will focus on reducing the pain. To discover more evidence-based information and resources for cancer, visit our dedicated hub. Type 1 diabetes is an autoimmune disease.
It occurs when the immune system attacks and destroys the beta cells in the pancreas so that they can no longer produce insulin. The exact cause remains unknown, but it may be due to genetic and environmental factors, including viruses.
This happens when cells cannot utilize the insulin the pancreas makes properly, or the pancreas cannot make enough insulin. As a result, the body can no longer control blood glucose levels. Other problems that can occur in relation to the pancreas include :.
Following a balanced diet and avoiding smoking and excessive drinking will help keep the pancreas healthy. The National Pancreatic Foundation recommends :.
The pancreas is a large gland that plays a vital role in the digestive system. It secretes enzymes that help break down food and produces insulin, which is vital for managing blood sugar.
Gallstones commonly form in the gallbladder. However, if a stone moves into the bile duct through the cystic duct , it can become impacted stuck at the exit into the duodenum papilla of Vater. This exit hole is normally shared with the pancreatic duct, so that an impacted stone can block the pancreas … and cause pancreatitis.
Alcohol causes acute pancreatitis by direct poisoning of the gland. Patients and pancreases vary in their sensitivity to alcohol. There is no completely safe level of consumption, and yet many people drink heavily for years without ever developing pancreatitis or other alcohol-related diseases such as liver and heart disease.
We do know that women are more sensitive to alcohol than men, and most authorities recommend three or less drinks per day for men, and two for women. Once pancreatitis has occurred, alcohol should be avoided completely. Alcohol can aggravate pancreatitis even if it has originally been caused by something else.
Pancreatitis can also be caused by tiny stones sludge or crystals which cannot be seen on standard X-ray tests and scans. They can be found by special techniques such as placing a tube into the duodenum duodenal drainage and stimulation of gallbladder contraction, or during an ERCP examination.
When stones, sludge or crystals are found, the gallbladder should be almost always removed via cholecystectomy. Symptoms are often severe enough as to require immediate medical attention and usually admission to hospital for pain medicines analgesics and intravenous IV fluids.
Normal levels of amylase and lipase do not completely rule out pancreatitis, especially when the pancreas has been damaged beforehand and therefore cannot produce much amylase or lipase.
More rarely, a similar clinical presentation can result from sudden loss of the blood supply to the intestines intestinal ischemia. Inflammation in acute pancreatitis involves the whole pancreas, so diabetes can result either temporary or permanent due to damage to the parts which normally produce insulin, known as islets of Langerhans.
Patients may need multidisciplinary care in an intensive care unit, including artificial ventilation and other forms of life support.
When gallstones cause a severe attack of acute pancreatitis, the treatment plan may include attempts to remove the stone s. This is usually first attempted by ERCP, but can also be done with a standard surgical operation. Unfortunately, there is no specific treatment for pancreatitis. Treatment for acute pancreatitis is largely supportive, such as:.
Antibiotics are needed when an infection is detected in the pancreas or other organs. There are experimental medicines aimed at reducing the secretion of pancreatic poisons, and neutralizing their effects. Patients may require treatment for local complications of pancreatitis, such as pseudocysts and abscesses.
When pseudocysts cause continuing symptoms such as pain or pressure on other organs , the fluid must be drained. This can be done by:.
When these are performed, it is usually necessary to leave a tube behind for continuing drainage. Most patients recover from acute attacks of pancreatitis with no residual complaints. Tests of the pancreatic function enzymes and insulin secretion and structure ultrasound and CT scans may return completely to normal.
However, it is very important to look carefully for causative factors such as heavy alcohol consumption and gallstones to help prevent further attacks. All causes must be carefully sought and eliminated where possible.
Blood tests will show when there is too much calcium or fat triglyceride. The presence of some form of duct obstruction can often be suspected by scanning ultrasound, CT or MRCP , because the duct may become larger dilated. However, examination for obstruction is best done with ERCP, which can examine the drainage systems in detail, including measurements of muscular activity.
Some causes of poor drainage can be treated during the ERCP examination by sphincterotomy or stenting, while others may require an open surgical operation. Health Medical Services Digestive Health Patients Digestive Diseases Pancreas Acute Pancreatitis.
Digestive Disease Center. About The DDC G. Digestive Diseases. Small Intestine. Digestive Organs. Chronic Pancreatitis Surgery.
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