Pancreatitis | |
---|---|
The pancreas and surrounding organs | |
Specialty | |
Symptoms | |
Complications | Infection, bleeding, diabetes mellitus,[1] pancreatic cancer, kidney failure, breathing problems, malnutrition[2] |
Duration | Short or long term[1] |
Causes | |
Risk factors | Smoking[3][4] |
Diagnostic method | Based on symptoms, blood amylase or lipase[5][1] |
Treatment | Intravenous fluids, pain medication, antibiotics[1] |
Frequency | 8.9 million (2015)[6] |
Deaths | 132,700 (2015)[7] |
Pancreatitis is a condition characterized by inflammation of the pancreas.[1] The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones.[1] There are two main types: acute pancreatitis, and chronic pancreatitis.[1]
Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting.[1] The pain often goes into the back and is usually severe.[1] In acute pancreatitis, a fever may occur; symptoms typically resolve in a few days.[1] In chronic pancreatitis, weight loss, fatty stool, and diarrhea may occur.[1][5] Complications may include infection, bleeding, diabetes mellitus, or problems with other organs.[1]
The two most common causes of acute pancreatitis are a gallstone blocking the common bile duct after the pancreatic duct has joined; and heavy alcohol use.[1] Other causes include direct trauma, certain medications, infections such as mumps, and tumors.[1] Chronic pancreatitis may develop as a result of acute pancreatitis.[1] It is most commonly due to many years of heavy alcohol use.[1]
Other causes include high levels of blood fats, high blood calcium, some medications, and certain genetic disorders, such as cystic fibrosis, among others.[1] Smoking increases the risk of both acute and chronic pancreatitis.[3][4] Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase.[1] In chronic pancreatitis, these tests may be normal.[1] Medical imaging such as ultrasound and CT scan may also be useful.[1]
Acute pancreatitis is usually treated with intravenous fluids, pain medication, and sometimes antibiotics.[1] Typically eating and drinking are disallowed, and a nasogastric tube is placed in the stomach.[1] A procedure known as an endoscopic retrograde cholangiopancreatography (ERCP) may be done to examine the distal common bile duct and remove a gallstone if present.[1] In those with gallstones the gallbladder is often also removed.[1] In chronic pancreatitis, in addition to the above, temporary feeding through a nasogastric tube may be used to provide adequate nutrition.[1] Long-term dietary changes and pancreatic enzyme replacement may be required.[1] Occasionally, surgery is done to remove parts of the pancreas.[1]
Globally, in 2015 about 8.9 million cases of pancreatitis occurred.[6] This resulted in 132,700 deaths, up from 83,000 deaths in 1990.[7][8] Acute pancreatitis occurs in about 30 per 100,000 people a year.[3] New cases of chronic pancreatitis develop in about 8 per 100,000 people a year and currently affect about 50 per 100,000 people in the United States.[9] It is more common in men than women.[1] Often chronic pancreatitis starts between the ages of 30 and 40 and is rare in children.[1] Acute pancreatitis was first described on autopsy in 1882 while chronic pancreatitis was first described in 1946.[9]