Acute pancreatitis is characterized by a sudden severe upper abdominal pain caused by inflammation of the pancreas. The pain may radiate to the back and may last for several days. The pain is relieved by leaning forward or sitting. Some patients may experience nausea, vomiting, abdominal distension, fever or jaundice (yellowing of the skin).
The common causes of acute pancreatitis in adults are:
- Excessive alcohol consumption
Other causes of acute pancreatitis include:
- Viral infections
- Trauma to the pancreas
- Surgical or endoscopic procedures of the common bile duct
- Drugs (such as thiazide diuretics, corticosteroids, and azathioprine)
- Unknown (idiopathic pancreatitis)
Laboratory tests including:
- Full blood count
- Renal panel
- Serum amylase and lipase
- Liver function tests
- Blood glucose test
- Serum calcium level
- Arterial blood gas analysis
Radiological investigations including:
- Chest and abdomen X-rays
- Abdominal ultrasound
- CT scan of the abdomen
- Endoscopic retrograde cholangiopancreatography (ERCP)
Majority of cases of acute pancreatitis are mild and self-resolving. However some patients may have severe acute pancreatitis which is associated with high mortality.
Depending on the severity of the pancreatitis, the patient may be nursed in the general ward, high dependency ward or surgical intensive care unit.
Immediate treatment may include:
- Withholding oral feeding
- Intravenous fluid resuscitation
- Pain relief
- Symptom control for vomiting
- Intravenous antibiotics, when infected is suspected
- Surgery may be necessary to control infection or bleeding.
Most patients with mild acute pancreatitis will recover fully.
The underlying cause of acute pancreatitis should be treated to prevent a recurrence. This includes:
- Removal of the gallbladder and gallstones in patients with gallstone pancreatitis (Cholecystectomy)
- Moderating alcohol intake
- Discontinuing medications that cause pancreatitis