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Definition Return to top
Acute pancreatitis is an inflammation (irritation and swelling) of the pancreas. The pancreas is a long gland, located behind the stomach, that secretes digestive enzymes and the hormones insulin and glucagon.
Causes Return to top
The chief causes of acute pancreatitis in adults are gallstones, other gallbladder (biliary) disease, and alcohol use. Other causes include:
Acute pancreatitis may also be caused by an abnormal structure of the pancreas, 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:
Symptoms Return to top
Additional symptoms that may be associated with this disease:
Exams and Tests Return to top
General examination may show fever, low blood pressure, rapid heart rate or rapid respiratory rate.
Tests that show release of pancreatic enzymes:
Test that show inflammation of the pancreas:
In other blood tests results:
Treatment Return to top
Treatment is aimed at supportive measures such as fluid replacement by intravenous (IV) infusion, pain relief, and withholding food or fluid by mouth (to limit the activity of the pancreas that makes symptoms worse). Occasionally nasogastric suctioning may be required, if there is persistent vomiting or severe pain, or if a paralytic ileus develops.
Recurrent attacks may be prevented by treating the underlying condition.
In some cases, radiologic or endoscopic therapy is needed to remove gallstones, relieve obstructions of the pancreatic duct, or drain fluid collections in or around the pancreas. In the most severe cases, surgery is necessary to remove dead, infected pancreatic tissue.
Outlook (Prognosis) Return to top
While most cases go away in a week, some cases develop into a life-threatening illness. The death rate is high with hemorrhagic pancreatitis or necrotizing pancreatitis, and complications such as liver, heart, or kidney impairment may occur. Recurrences are common.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your provider if intense, constant abdominal pain is present, or if other symptoms suggestive of acute pancreatitis develop.
Prevention Return to top
Prevention of acute pancreatitis is associated with prevention of the disorders that cause it:
If you develop acute pancreatitis as a result of alcohol use, you should avoid all alcohol in the future. If you develop acute pancreatitis as a result of a medication, avoid the medication in the future.
References Return to top
Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006 Oct;101(10):2379-400.
Update Date: 5/4/2006 Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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Page last updated: 26 June 2008 |