PANCREATITIS

By Gisela G. Luna

Pancreas

• The pancreas is a narrow, flat glandular organ measuring 12 to 20 cm long;

• located inside the abdominal cavity, behind the stomach and below the liver.
It has 4 (four) sections - head, neck, body, and tail.
• Its head section connects to the first part of the small intestine (duodenum),
• the neck is located near the superior mesenteric vessels,
• the body lies behind the posterior wall of the stomach, and
• the tail extends to the spleen.
• The common bile duct also goes through the head section of the pancreas,
carrying bile from the liver and gallbladder into the small intestine. The bile
duct and pancreatic duct usually connect together before entering the
duodenum and share a
• common opening into the small intestine.

function

• The Pancreas secret pancreatic juice (a transparent fluid consists of

electrolytes, water, and enzymes)
• that is rich in proteins and consists of bicarbonate fluid, digesting enzyme
such as amylase, trypsin, nucleases, elastase, chymotrypsinogen,
carboxypeptidase and lipase,
these enzymes are essential for the digestion of fat, protein, fat, and
carbohydrate in the food.

2 important functions
1. Exocrine function
 It releases digestive enzymes to break down and digest fats, foods,
carbohydrates, and proteins in our small intestine.
 The enzymes normally are produced and carried in an inactive form to the
small intestine, where the enzymes are activated as needed.
 It also makes and releases bicarbonate that neutralizes stomach acids and
allows for the activation of pancreatic enzymes.

Endocrine function
• it produces five hormones, beta cells secrete insulin, alpha cells secrete
glucagon, delta cells secrete somatostatin, epsilon cells secrete ghrelin and
PP (gamma) cells secrete pancreatic polypeptide; and releases them into the
blood.
• These hormones regulate sugar (glucose) transport into the body's cells,
where it is used for energy and to help maintain normal blood sugar levels

What is pancreatitis?

Pancreatitis is a sudden inflammation of the pancreas

It is difficult to find it in the early stages.
Pancreatitis is curable if diagnosed at the acute stage
chronic pancreatitis is not curable.
However, symptoms and associated pain may be prevented or managed.

Pancreatitis
occurs when its digestive juices, or enzymes become activated inside pancreas
and start damaging pancreas;
 causing injury and irritation to pancreas and leading to inflammation.
 It can be a mild, short term condition and self-limiting
 or it can cause severe life-threatening complications that can remain for
many years.

Types of pancreatitis

• Acute pancreatitis
  is a short term condition and occurs suddenly; causing inflammation of the
pancreas.
 Acute pancreatitis may be mild and can develop further complications if
not treated and monitored properly,
 such as necrotizing pancreatitis, pancreas infection, pancreatic pseudocyst,
or organ failure
• Signs of acute pancreatitis
• Severe abdominal pain,
• tender and swollen belly,
• diarrhea,
• nausea,
• bloating,
• vomiting
• and fever
• Chronic pancreatitis 
 is a long-term condition, causing inflammation of the pancreas.
 It is a progressive disorder associated with the damaging of the tissues of the
pancreas that cannot be reversed.
 It is more common in male aged between 32 and 45 years.
 it is a long-term progressive disease; causing permanent damage to the
pancreas
• chronic pancreatitis

patient can develop

 unwanted weight loss
 Malnutrition
 and malabsorption.
• Hereditary pancreatitis 
 is a rare genetic condition that occur due to recurrent pancreatic attacks
 which can lead to chronic pancreatitis
 cannot be cured completely but can be managed by medical management,
such as:
 Pancreatic enzyme supplements, insulin for diabetes, medications for pain,
and lifestyle change to reduce risk for pancreatic cancer

• Pancreatic cancer 
 when uncontrolled cell growth begins in the tissues of the pancreas
 Cancerous and noncancerous tumors growths can occur in the pancreas
 Pancreatic cancer can be cured if detected early
 It can also slow down the production of digestive enzymes by the pancreas,
resulting in difficulty to break down food and absorbing nutrients.
 causing bloating
 watery, greasy, foul-smelling stool,
 leading to weight loss and
 vitamin deficiencies.
• Causes of Pancreatitis
• Moderate or heavy alcohol consumption and smoking (25% cases of
pancreatitis)
• Gallbladder stone (40% cases of acute pancreatitis)
• Hormonal abnormalities
• Abdominal injury
• Hereditary conditions
• Obesity
• Recurrent acute pancreatitis can cause chronic pancreatitis
• Cystic fibrosis (inherited life-threatening disorder that damages the digestive
system and lungs)
• Certain Medications
• Increased level of triglycerides (fat in a blood that gives energy)
• Abdominal surgery

•
Symptoms of Pancreatitis

Symptoms of acute pancreatitis

• Fever
• Higher heart rate
• Nausea and vomiting
• Swollen and tender belly
• Pain in the upper part of the belly that radiates to the back,
• Eating may make it worse, especially foods high in fat

Symptoms of chronic pancreatitis

symptoms of chronic pancreatitis are similar to those of acute pancreatitis.

But may experience:
• Constant pain in the upper belly that radiates to your back. This pain may be
disabling.
• Diarrhea and weight loss because of the pancreas is not releasing enough
enzymes to break down food
• Upset stomach and vomiting
Complications

•  Diabetes if there is damage to the cells that produce insulin

• Infection of the pancreas
• Kidney failure
• Malnutrition if the body cannot get enough nutrients from the food because
of a lack of digestive enzymes
• Pancreatic cancer
• Pancreatic necrosis, when tissues die because the pancreas is not getting
enough blood
• Problems with breathing when chemical changes in the body affect the lungs
• Pseudocysts, when fluid collects in pockets of the pancreas. It can burst and
become infected.

• Diagnostic Tests

• Imaging tests
• Blood tests
• Fecalysis
• pancreatic function test

• Treatment for acute pancreatitis

 Strong drugs for pain

 Gastric suctioning
 Antibiotics
 IV therapy
 Low fat diet or NPO

Treatment for chronic pancreatitis

Pain killers
Pancreatic enzyme therapy
Insulin for diabetes
Surgery to relieve pain
 Nursing Management

Nursing Assessment
• Diagnosis
• Planning & Goals
• Nursing Interventions
• Evaluation