Pancreatitis

The pancreas regulates the amount of glucose in the blood through the release of various hormones, with insulin being the most important in the process. The pancreas is said to be an organ with both exocrine and endocrine function.

Bruce Blaus. Own work, CC BY 3.0

Inflammation of the pancreas, or pancreatitis, is a process generally associated with the presence of stones in the gallbladder. In fact, it is one of the complications of this disease and one of the reasons why it is recommended that the patient undergoes surgery to remove the gallbladder as soon as the gallstones are diagnosed. When one of the gallbladder stones is too large to pass through the bile duct, it blocks the flow of bile and pancreatic fluid. This begins the inflammatory process that leads to pancreatitis.

www.scientificanimations.com, CC BY-SA 4.0

The other major cause of pancreatitis is the patient’s lifestyle. Obesity, high fat intake, high triglyceride levels, above 1000mg/dL, alcohol, and smoking are all triggers for pancreatitis. The main symptom of pancreatitis is a dull pain that wraps around the upper abdomen and involves the back. In Spanish, it is called a “bandlike pain pattern.” The definitive diagnosis is made by performing a CT scan of the abdomen that shows an enlarged pancreas and laboratory tests for pancreatic enzymes: Lipase and Amylase, which will be found to be elevated to about three times the upper limit of normal. The problem with having a disease like pancreatitis is that its complications are serious, such as diabetes, and can even be fatal. When pancreatitis is suspected, it is important to start decreasing the intake of fats and grains to give the pancreas a rest. The emergency service should be contacted immediately. A patient with suspected pancreatitis should be studied with the corresponding laboratory and imaging tests to corroborate the diagnosis. In the event that the resultant pancreatitis is a gallstone obstruction, the blockage should be removed as soon as possible. This is done through a specialized study called endoscopic retrograde cholangiopancreatography (ERCP) and should not be postponed since complications include infection, sepsis, and death.

Drus1a, Own work, CC BY-SA 4.0

Pancreatitis is a medical emergency that must be treated right away. However, if this is not possible, some of the patient’s signs that indicate worsening should be taken into account: fever, increased breathing rate, continuous and progressive pain, and purple on the sides and around the navel. These signs denote necrosis and destruction of pancreatic tissue that will likely require surgery and management in the ICU.

Herbert L. Fred, MD and Hendrik A. van Dijk, CC BY 2.0

Herbert L. Fred, MD and Hendrik A. van Dijk, CC BY 2.0