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Pancreatitis

Background

Acute pancreatitis (inflammation of the pancreas) may be mild or severe.

The pancreas gland lies behind the stomach. It secretes digestive juices containing enzymes into the first part of the intestine (duodenum) which helps to breakdown food into small particles that can be absorbed by the body's digestive system.

The pancreas ducts also secrete bicarbonate into the duodenum to counter the acid from the stomach and help make the enzymes work better.

There are also islets of Langerhans in the pancreas, which produce insulin to keep the circulating blood sugar (glucose) concentrations at the correct level. This is known as endocrine function.

Normally pancreas enzymes only become active once they reach the duodenum. However, in acute pancreatitis the pancreas enzymes become activated before they reach the duodenum and they start to 'digest' the pancreas itself, causing further inflammation.

Credits

Last updated February 2014 by Professor JP Neoptolemos, Professor of Surgery, NIHR Pancreas Biomedical Research Unit, Royal Liverpool University Hospital and the University of Liverpool, UK.

What are the symptoms?

People with acute pancreatitis suffer moderate to severe pain in the upper abdomen. This comes on suddenly and usually also moves through to the back. There is a feeling of sickness (nausea) and often vomiting with loss of appetite. There is tenderness on touching the abdomen and the pain will force people to lie down and be still. Lots of fluid moves into the inflamed tissues and may cause a fall in blood pressure making the person become sweaty and feverish. These symptoms gradually resolve in most people over a few days to a week.

In severe cases the lungs and kidneys become seriously damaged and the pancreas gland may be partly or completely destroyed in a form of gangrene (pancreatic necrosis) and if untreated will cause death.

What are the causes?

The main causes are gallstones or alcohol but also injury by accidents or instrumentation, medications and infections. In about 1% this is due to inherited genes.

How is it diagnosed?

By measuring the level of a pancreas enzyme (amylase) from a blood sample, and in severe cases using a computerized tomography (CT body) scan.

How is it treated?

Fluid is replaced by using a vein drip, along with injections to relieve pain. Pulse rate, blood pressure and urine output are also regularly measured. In severe cases, treatment will be needed on an intensive care unit. Dead and infected pancreatic tissue will be removed by inserting tubes and instruments and surgery.

To avoid recurrent attacks the gallbladder should be removed if due to gallstones and abstinence if due to alcohol.

Inheritance patterns and prenatal diagnosis

Inheritance patterns
An altered PRSS1 gene causes inherited pancreatitis with 30-40% of individuals in a family developing symptoms. Other inherited genetic alterations just increase the risk without affecting multiple family members (SPINK1, CFTR and CLDN2).

Prenatal diagnosis
Not applicable.

Is there support?

Pancreatitis Supporters Network

Tel: 07949 973430
Email: psn@pancreatitis.org.uk
www.pancreatitis.org.uk

The Network is a Registered Charity in England and Wales No. 1027443. It provides information and support to anyone affected by pancreatitis. The Network runs an online discussion forum and a pen pal scheme.

Group details last updated February 2016.

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