Definition

The pancreas is a long, flat, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones, including insulin. Acute pancreatitis is inflammation of the pancreas that occurs suddenly and resolves with proper treatment.

Pancreatitis Copyright © Nucleus Medical Media, Inc.

Causes

Pancreatitis occurs when digestive enzymes are activated in the pancreas instead of the small intestine. Acute pancreatitis has several causes. In some cases, the cause may be unknown.

Known causes of acute pancreatitis include

• Obstruction of the pancreatic duct from:
  • Gallstones
  • Cancer
  • Diseases of the duodenum, the first section of the small intestine, where the pancreas empties
• Alcohol
• Surgery or trauma to the pancreas
• Certain medications, such as those that treat cancer
• Ischemia—insufficient blood supply to the pancreas
• Complications of having endoscopic retrograde cholangiopancreatography

Risk Factors

Factors that may increase your risk of acute pancreatitis include:

• Alcohol abuse
• Family history of pancreatitis
• Personal history of previous acute pancreatitis
• Congenital conditions, such as pancreas divisum
• HIV or other viral infections, such as mumps or hepatitis B
• Bacterial and parasitic infections
• Hypertriglyceridemia —elevated blood triglyceride levels
• Taking certain medications, such as those that treat high blood pressure
• Pancreatic cancer
• Hyperlipidemia —elevated blood fat levels
• Hypercalcemia —elevated blood calcium levels
• Cystic fibrosis
• Scorpion bite
• Occupational exposure to certain toxins

Symptoms

Symptoms may occur one time or many times. Repeated flare ups of symptoms are known as attacks.

Acute pancreatitis may cause:

• Severe pain in the center of the upper abdomen that:
  • Sometimes spreads into the upper back
  • Is often made worse by eating, walking, or lying down on your back
• Nausea and vomiting
• Low grade fever
• Jaundice —yellowing of the skin and eyes
• Rarely, shock —a medical emergency in which the organs and tissues don’t receive adequate blood or fluids

Untreated acute pancreatitis may progress into chronic pancreatitis, a serious condition where the pancreas becomes permanently damaged.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will ask how much alcohol you drink and what medications you take. Diagnosis can be determined by your symptoms and results from blood tests.

Your body fluids may be tested. This can be done with:

• Blood tests
• Urine tests

Images may be taken of your body structures. This can be done with:

• Abdominal ultrasound
• Abdominal CT scan
• Abdominal MRI scan
• Magnetic resonance cholangiopancreatography (MRCP)

Treatment

Treatment for acute pancreatitis depends on the severity of the attack and what is causing it. For example, if medication is the cause of your pancreatitis, your doctor may change to a different medication or adjust the dose.

In most cases, acute pancreatitis isn’t severe and can be treated. Treatment includes:

Prevention

To help reduce your chance of getting acute pancreatitis, take these steps:

• Limit intake of alcohol to a maximum of 2 drinks per day for men and 1 drink per day for women.
• If you have hyperlipidemia, restrict your intake of fat and follow your doctor’s treatment plan to lower your lipids.
• Increase your vegetable consumption.
• Increase your activity level to help lose excess weight. Aim for 30 minutes per day on most days of the week.
• Make sure your vaccinations are up to date. This includes mumps, rubella, hepatitis B, and varicella.

National Pancreas Foundation http://www.pancreasfoundation.org

Health Canada http://www.hc-sc.gc.ca

Acute pancreatitis. Tulane University School of Medicine website. Available at:
http://tulane.edu/som/pancreas-biliary/diseases/acute-pancreatitis.cfm
Accessed December 11, 2014.

Causes of acute pancreatitis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated October 31, 2013. Accessed December 11, 2014.

Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis
Updated August 16, 2012. Accessed December 11, 2014.

Prevention of acute pancreatitis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated July 7, 2014. Accessed December 11, 2014.

4/7/2014 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Baker ME, Nelson RC, et al. ACR Appropriateness Criteria for acute pancreatitis. American College of Radiology (ACR); 2013. 11 p. Available at: http://www.guideline.gov/content.aspx?id=47649. Accessed April 7, 2014.

8/28/2014 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Johnson CD, Besselink MG, et al. Acute pancreatitis. BMJ. 2014 Aug 12;349:g4859.