Acute pancreatitis

Definition

Acute pancreatitis is an inflammation (irritation and swelling) of the pancreas. The pancreas is an elongated, tapered gland, located behind the stomach, that secretes digestive enzymes and the hormones insulin and glucagon.

Causes, incidence, and risk factors

The chief causes of acute pancreatitis in adults are gallstones, other gallbladder (biliary) disease, and alcohol use. Viral infection (Mumps, coxsackie B, mycoplasma pneumonia, and campylobacter), traumatic injury, pancreatic or common bile duct surgical procedures and certain medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine) are other causes. Acute pancreatitis may also be caused by abnormal anatomy of the pancreas (pancreas divisum), genetic factors (hereditary pancreatitis), high lipid levels in the blood (hypertriglyceridemia), and complications of Cystic fibrosis.

The mechanism that causes pancreatitis is not well known. It is thought that enzymes normally secreted by the pancreas in an inactive form become activated inside the pancreas and start to digest the pancreatic tissue. This process is called autodigestion and causes swelling, hemorrhage, and damage to the blood vessels.

The disease affects men more often than women. Alcohol Abuse is an important risk factor.

In children, this disorder may be associated with:

• Abdominal trauma
  
• Cystic fibrosis
  
• Hemolytic uremic syndrome
  
• Kawasaki disease
  
• Mumps
  
• Reye syndrome
  
• Various viral illnesses
  
• Some medications
  

Symptoms

• Abdominal pain that is greatest in the upper abdomen (upper left quadrant or upper middle of the abdomen)
  o Is persistent or chronic
  o May be worse lying flat on the back
  o May radiate to the back or below the left shoulder blade
  o May be worse after eating or drinking (occurs within minutes following meals), especially foods with a high fat content
  o May be worse after drinking alcohol
  
• nausea and Vomiting
  
• Sweating