Acute Pancreatitis

Definition

Acute pancreatitis is sudden inflammation of the pancreas. The pancreas is an organ that sits behind the stomach. It makes fluids that help to break down food in the small intestine.

The Pancreas

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Causes

Causes may be:

• Gallstones —block flow of fluid out of pancreas
• Alcohol use disorder
• Certain medicines, such as corticosteroids, opioids, and valproate
• High triglyceride levels
• Abdominal trauma
• Complications of endoscopic retrograde cholangiopancreatography (ERCP)

Sometimes the cause is not known.

Risk Factors

The risk of this problem is higher in people who have any of the causes listed above.

Other things that may raise the risk of this problem are:

• Having other family members who have had this problem
• Obesity
• Type 2 diabetes
• Tobacco use disorder
• Exposure to certain toxins at work or in the environment

Symptoms

The main problem is mild to severe pain in the center of the belly. It may also spread into the upper back. This pain may last several days.

Other problems may be:

• Swollen belly
• Nausea and vomiting
• Fever

Diagnosis

The doctor will ask about your symptoms and health history. You may be asked about your use of alcohol. A physical exam will be done. It will focus on the belly.

The doctor may suspect pancreatitis based on your pain. Other tests will help to make the diagnosis. Tests may include:

Blood tests will be done to look for signs of pancreatitis.

Images of the pancreas will be taken. This can be done with:

• Abdominal ultrasound
• Abdominal CT scan
• Abdominal MRI scan
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic resonance cholangiopancreatography (MRCP)

Treatment

Any underlying causes will need to be treated.

Most people recover in a few days. The goal of treatment is to manage symptoms during this time. Choices are:

• Supportive care, such as drinking extra fluids or getting fluids through an IV
• Dietary changes, such as a low fat diet or nutrition given through a tube that is passed through the nose and into the stomach
• Medicines to ease pain

People who are not helped by these methods may need surgery. The type of surgery done depends on the reason for the pancreatitis. Some choices are:

• Percutaneous catheter drainage to drain fluid from the pancreas
• ERCP to remove gallstones
• Cholecystectomy to remove the gallbladder if gallstones are the cause
• Necrosectomy to remove dying or dead tissue from the pancreas

Prevention

To lower the risk of this health problem:

• Manage chronic health problems, such as high triglycerides and obesity
• Limit alcohol