The pancreas is an organ within the abdomen behind the stomach. The pancreas has two main functions: it helps produce enzymes that aid in digestion and also secretes insulin that helps the body control blood sugar levels. Within the pancreas, there are specialized cells called acinar cells that are responsible for producing the digestive enzymes that help us break down fats and proteins. Also within the pancreas, there are specialized cells termed islets which make insulin and other hormones.
Acute pancreatitis is a condition characterized by abrupt inflammation of the pancreas characterized by swelling and at times even destruction of pancreatic tissue. The most common causes of acute pancreatitis are gallstones and excessive alcohol consumption. Other causes include smoking, high triglyceride levels, high calcium levels, certain medications, abdominal trauma, viral infections, structural anatomic anomalies and genetic abnormalities. Chronic pancreatitis occurs when there is irreversible scar tissue that forms in the pancreas as a result of ongoing inflammation. Chronic pancreatitis can lead to impaired digestion of food and diabetes mellitus. The most common causes of chronic pancreatitis are excessive consumption of alcohol, heavy smoking, and recurrent episodes of acute pancreatitis for any number of reasons including genetic mutations. However, the cause is unknown in nearly a third of patients, despite an extensive evaluation.
The diagnosis of acute pancreatitis is made by a combination of symptoms, physical exam findings, and laboratory tests including amylase and lipase. If the diagnosis is uncertain, abdominal imaging studies such as a computed tomography (CT) scan may also be necessary.
Chronic pancreatitis is characterized by intermittent or constant upper abdominal pain. Other features of chronic pancreatitis include greasy or oily stool as well as difficult to control diabetes. The diagnosis of chronic pancreatitis is made by a combination of clinical symptoms and imaging studies such as abdominal CT scan, magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and/or endoscopic retrograde cholangiopancreatography (ERCP).
If you are experiencing severe abdominal pain, call your doctor or go to the nearest emergency room. The doctor will take a medical history, perform a physical examination, and draw blood to tests for pancreatic enzymes (amylase and lipase). An ultrasound of the abdomen may be performed to exclude the presence of gallstones. Other abdominal imaging tests such as a CT scan or MRI may also be performed. Endoscopic procedures such as ERCP or EUS may also be warranted in some patients.
Gallstone Pancreatitis – surgical removal of the gall bladderAlcohol/tobacco induced Pancreatitis – strict abstinence from alcohol and/or tobacco
Drug Induced Pancreatitis – avoid offending medication
Drug Induced Pancreatitis – avoid offending medicationHypertriglyceridemia – aggressive lipid-lowering agentsAvoidance of high fat foods, consuming diets rich in vegetables, and maintaining adequate fluid intake
Bile – A secretion from the liver that assists in digesting fats.
Biliary System – The ducts and tubes that collect and drain bile in to the intestine.
CT Scan – Computerized tomography is a specialized radiologic test for imaging the pancreas and other intra-abdominal organs.
ECRP (Endoscopic Retrograde Cholangiopancreatography) – A procedure utilizing a long, narrow, flexible tube called an endoscope that is introduced via the mouth into the small intestine to examine the pancreatic duct and bile ducts.
EUS – An endoscopic test for imaging the pancreas and other intra-abdominal organs.
Diabetes Mellitus – A condition characterized by an abnormally elevated blood sugar level. One cause is failure of the pancreas to secrete enough insulin when a patient has severe chronic pancreatitis.
Endocrine – The portion of the gland that releases insulin directly into the blood stream.
Exocrine – The portion of the gland that secretes pancreatic juice via the pancreatic duct into the small intestine.
Inflammation – A response to tissue injury that results in redness, swelling, and pain.
MRI – Magnetic resonance imaging is a radiologic test for imaging the pancreas and other intra-abdominal organs. It also visualizes the pancreatic and bile ducts.
Pancreas – The pancreas is an organ within the abdomen that is responsible for digestion of food and control of blood sugar.
Pancreatic duct – Drains pancreatic enzymes into the duodenum.
Ultrasonography (Ultrasound) – A radiologic test for imaging the pancreas and other intra-abdominal organs. It is particularly useful in visualizing the liver and gall bladder.
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