What causes acute pancreatitis?
There are many causes of pancreatitis including:
- Gallstones
- Excess alcohol intake
- Certain medications
- Following a procedure called endoscopic retrograde cholangiopancreatography (ERCP)
- High fat levels in the blood also known as familial hypertriglyceridemia
What at the symptoms of acute pancreatitis?
- Sudden onset severe abdominal pain in the upper middle abdomen
- Pain may radiate to the sides or through to the back
- With alcohol pancreatitis, symptoms usually start soon after an alcohol binge
- Nausea
- Vomiting
How is pancreatitis diagnosed?
Diagnosis is usually made from the history, examination and blood tests of the patient.
- Patients classically have central abdominal pain that radiates to the back
- The blood tests indicate an at least 3 fold increase in the enzymes produced by the pancreas
- Imaging such as a CT or MRI scan will demonstrate inflammation of the pancreas with a dilated duct. It may also demonstrate a cause of the stones such as gallstones
How is pancreatitis treated?
The management of pancreatitis can be quite complex as symptoms can be very severe:
- Supportive management including IV fluids, strong pain killers and very close monitoring
- Admission to intensive care unit may be needed where intravenous fluids will be administered.
- Eating and drinking may be limited due to the need to rest the gut. In such instances feeding via a nasogastric may be required
- Antibiotics may or may not be used depending on the appearance of the pancreas on imaging. If the pancreas is damaged with evidence of infection then antibiotics are indicated
- If the damage or infection of the pancreas is severe then this may need to be drained via the stomach or through the skin.
- In patients whom the pancreatitis is secondary to gallstones; eventually an operation to remove the gallbladder will need to be performed. This is known as a cholecystectomy.
How long will I be in hospital and what is the recovery period and follow up?
- The length of stay is dependent on the severity of pancreatitis
- It can vary from a few days to weeks or months
- Upon discharge patients are advised to withdraw from alcohol
- If the pancreatitis is due to stones, then a cholecystectomy (operation to remove the gallbladder) is advised and to be done 6 weeks after admission for pancreatitis
- Depending on the severity 2-4 weeks off work may be needed
- Patients will be reviewed in clinic 4-6 weeks after discharge