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Acute pancreatitis is an acute inflammation of the pancreas which may range from mild to life-threatening. It is usually associated with necrosis of the pancreas and the surrounding tissue, and can also involve other body systems, leading to systemic complications.
Due to its severe complications, acute pancreatitis should be diagnosed and treated as quickly as possible. The treatment mainly involves supportive measures to prevent complications.
Acute Pancreatitis: Causes
Acute inflammation in the pancreas is triggered by its own enzymes: trypsin, lipase and amylase. Normally, these enzymes lie dormant inside the pancreas until they are released in order to aid food digestion. In acute pancreatitis, these enzymes are somehow activated prematurely inside the pancreas and start “digesting” pancreatic tissue.
Common causes of acute pancreatitis are alcohol abuse, gallstones, trauma, infections and hypercalcemia. All these factors somehow activate the pancreatic enzymes before they are even released, leading to acute inflammation. This inflammation is accompanied by necrosis of the pancreas and peri-pancreatic fat.
Recognizing Acute Pancreatitis: Symptoms To Watch Out For
The hallmark symptom of acute pancreatitis is upper abdominal pain. This pain is dull or vague in nature and radiates towards the back. It is accompanied by fever, nausea, vomiting and sweating however the pain is the chief symptom that brings most patients to the hospital.
The complications of acute pancreatitis can be very dangerous and should be dealt with immediately. These include acute respiratory distress syndrome (ARDS), hypovolemic shock, disseminated intravascular coagulation (DIC), hypocalcemia and ultimately multiple organ failure which may cause death.
Diagnosing Acute Pancreatitis
A diagnosis is made by looking at a patient's medical history and performing a clinical examination. Serum levels of amylase and lipase (pancreatic enzymes) are used to confirm the diagnosis. Their levels are raised in acute pancreatitis because they leak into the blood from inflammed pancreas. In addition, patients may undergo CT and MRI scans to localize the disease.
One popular criterion is the Ranson Score, in which the severity is predicted on a scale of 0 to 11. Lower scores mean mild acute pancreatitis and higher scores predict a severe or even fatal attack of pancreatitis. Milder forms of acute pancreatitis are generally treated successfully with only supportive measures, whereas severe acute pancreatitis may even necessitate surgery.