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what is pancreatitis

diagram of pancreas and abdomen

The pancreas is a remarkable gland that sits deep in the abdomen, lying behind the stomach that secretes digestive juices into the duodenum - the first part of the intestine - to help us break down food into the small molecules that can be absorbed by the body (digestive function). It also secretes insulin into the bloodstream to keep the concentration of glucose in our blood at the right level (endocrine function).

When the pancreas becomes inflamed, its own enzymes are released into the blood, as well as within the organ itself; though the highly active enzymes are usually contained in protected ductal areas, in the inflamed pancreas they start to "digest" the pancreas itself causing further inflammation.

Symptoms

Almost all victims of acute pancreatitis suffer very severe mid and upper abdominal pain, frequently radiating straight through to the back. Vomiting is common, and often early signs of shock are seen. Large amounts of fluid may pour into the abdominal cavity which, when combined with the vomiting and poor intake, leave the circulation with inadequate volumes to maintain a normal blood pressure. Ultimately, shock and death may occur. The intensely tender abdomen may mimic that seen in many other conditions, and requires careful differentiation from surgically treatable diseases; surgery in the presence of pancreatitis is very dangerous.

Treatment

Treatment is aimed at replacing large amounts of body fluid by vein. The pancreas and digestive system in general should be "shut down" to minimize enzyme production through the use of a stomach tube and/or regular antacids to neutralize acid production. Large doses of injected narcotic pain relievers may be necessary.

Complications

In a minority of patients, infection may set in from bacteria in the intestinal tract, requiring massive antibiotic treatment, which is not always successful. Still others develop severe bleeding from the raw and inflamed pancreas, or develop a highly aggressive pus-forming pancreatic involvement. With these complications, up to 90% of patients may die.