Acute Pancreatitis: Knowing the Causes, Symptoms, and Treatment
Acute pancreatitis is an inflammatory disorder affecting the exocrine portion of the pancreas. The pancreas, known for its dual role in endocrine and exocrine functions, can face various triggers leading to acute pancreatitis.
Common Causes
Gallstone Disease (Biliary Pancreatitis): Accounting for around 75 % of cases, gallstone-related pancreatitis is caused by the reflux of contaminated bile triggered by an obstruction at the distal common bile duct or sphincter of Oddi by a stone dislodged from the gallbladder.
Alcoholic Pancreatitis: Unlike the liver, there is no defined toxicity threshold of alcohol for the pancreas. Ethanol in alcoholic beverages damages acinar cells through multiple mechanisms, including inflammation pathways and enzyme activation.
Nonbiliary, Nonalcoholic Causes: Hyperlipidemia, drug-induced factors, infections such as mumps and viral hepatitis, and post-ERCP complications are among the nonbiliary, nonalcoholic causes.
Alarming Symptoms and Signs
- Acute abdominal pain radiating to the back and improving with forward leaning.
- Elevated amylase and lipase levels within the first 24 hours of presentation.
- Tachycardia, hypotension, and fever in severe cases.
- Predictive markers like CRP, HCT, and procalcitonin can aid in assessing severity.
Diagnostic Tools
Abdominal Ultrasound: Detects gallstones and ascitic fluid.
Contrast Pancreatic CT Scan: Evaluates necrosis, infections, and other collections.
Pancreatic MRI and MRCP: Provides detailed pancreatic anatomy.
Management Strategies
Pain Management: Effective pain relief is a priority, using a range of analgesics, including NSAIDs, weak opioids, and strong opioids, administered through various routes.
Fluids: Correcting hypovolemia with fluid resuscitation to normalize circulatory signs.
Antibiotics: Limited role in preventing infective pancreatic necrosis.
Nutrition: Early enteral feeding is recommended.
Systemic Complications: Addressing SIRS, MODS, coagulation disorders, respiratory and renal failure, and mesenteric ischemia.
Local Complications: Monitoring and interventions for peripancreatic collections, sterile necrosis, hemorrhagic necrosis, GI perforation, and infected necrosis.
Types of Interventions
Surgical Measures
Open necrosectomy with closed or open packing and continuous closed post-op lavage.
Minimally Invasive Measures
Endoscopy and interventional radiology-assisted drainage.
At Burjeel Medical City, our expert team provides a comprehensive approach to diagnosing and managing acute pancreatitis. By understanding the causes, symptoms, and treatment options outlined in this guide, both patients and healthcare professionals can collaborate for optimal outcomes. For any queries or to schedule an appointment, please contact us at 800 23.
