What is acute pancreatitis?

The pancreas is an organ that lies behind the stomach in the centre of the abdomen. The function of the pancreas is to produce  Acute pancreatitis is inflammation of the pancreas. 



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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

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