PANCREAS

PANCREATIC DISORDERS
CONTENTS:

• PANCREAS( LOCATION AND FUNCTION)

• PANCREATIC DISORDERS
• SYMPTOMS
• DIAGNOSIS
• TREATMENT
The pancreas is an organ located in the abdomen. It plays an essential role
in converting the food we eat into fuel for the body's cells. The pancreas
has two main functions: an exocrine function that helps in digestion and
an endocrine function that regulates blood sugar.
LOCATION OF THE PANCREAS
The pancreas is located behind the stomach in the upper left abdomen. It is surrounded by other
organs including the small intestine, liver, and spleen. It is spongy, about six to ten inches long,
and is shaped like a flat pear or a fish extended horizontally across the abdomen.
1.The wide part, called the head of the pancreas, is positioned toward the center of the
abdomen.
2.The central section of the pancreas is called the neck or body.
3.The thin end is called the tail and extends to the left side.
FUNCTIONS OF THE PANCREAS
Exocrine Function:
The pancreas contains exocrine glands that
produce enzymes important to digestion. These enzymes
include trypsin and chymotrypsin to digest proteins;
amylase for the digestion of carbohydrates; and lipase to
break down fats. When food enters the stomach, these
pancreatic juices are released into a system of ducts that
culminate in the main pancreatic duct. The pancreatic
duct joins the common bile duct to form the ampulla of
Vater which is located at the first portion of the small
intestine, called the duodenum. The common bile duct
originates in the liver and the gallbladder and produces
another important digestive juice called bile. The
pancreatic juices and bile that are released into the
duodenum, help the body to digest fats, carbohydrates,
and proteins.
Endocrine Function:
The endocrine component of the pancreas consists of islet cells (islets of
Langerhans) that create and release important hormones directly into the
bloodstream. Two of the main pancreatic hormones are insulin, which
acts to lower blood sugar, and glucagon, which acts to raise blood sugar.
Maintaining proper blood sugar levels is crucial to the functioning of key
organs including the brain, liver, and kidneys.
Pancreatatis is a disease in which the pancreas becomes
inflamed. Pancreatic damage happens when the digestive
enzymes are activated before they are released into the
small intestine and begin attacking the pancreas
There are two forms of pancreatitis:

1. Acute
2. Chronic
Acute pancreatitis. Acute pancreatitis is a
sudden inflammation that lasts for a short time. It may
range from mild discomfort to a severe, life-threatening
illness. Most people with acute pancreatitis recover
completely after getting the right treatment. In severe
cases, acute pancreatitis can result in bleeding into the
gland, serious tissue damage, infection,
and cyst formation. Severe pancreatitis can also harm
other vital organs such as the heart, lungs, and kidneys.
Chronic pancreatitis. Chronic pancreatitis is long-
lasting inflammation of the pancreas. It most often
happens after an episode of acute pancreatitis. Heavy
alcohol drinking is another big cause. Damage to the
pancreas from heavy alcohol use may not cause
symptoms for many years, but then the person may
suddenly develop severe pancreatitis symptoms.
Figure 1. Features of chronic pancreatitis.Chronic
pancreatitis is progressive inflammatory process in the
pancreas that causes fibrosis (scarring of tissue),
calcifications or stones, and dilated pancreatic duct.
Adapted from Gorelick F, Pandol, SJ, Topazian M.
Pancreatic physiology, pathophysiology, acute and chronic
pancreatitis. Gastrointestinal Teaching Project, American
Gastroenterological Association. 2003.
Figure 3: Causes of chronic pancreatitis.The most
common cause of chronic pancreatitis in the United States
is alcohol and smoking. Other causes include genetic
mutations, cystic fibrosis, hypercalcemia (or elevated
calcium levels in the blood), hypertriglyceridemia (or
elevated levels of triglycerides in the blood), autoimmune,
or idiopathic, meaning that the cause is still unknown.
Fibrocalcific pancreatitis, also known as tropical
pancreatitis, is more common in India.
Symptoms of acute pancreatitis:
•Upper abdominal pain that radiates into the back; it may
be aggravated by eating, especially foods high in fat.
•Swollen and tender abdomen
•Nausea and vomiting
•Fever
•Increased heart rate
Symptoms of chronic pancreatitis:
The symptoms of chronic pancreatitis are similar to those
of acute pancreatitis. Patients frequently feel constant
pain in the upper abdomen that radiates to the back. In
some patients, the pain may be disabling. Other
symptoms are diarrhea and weight loss caused by poor
absorption (malabsorption) of food. This malabsorption
happens because the gland is not releasing enough
enzymes to break down food. Also, diabetes may develop
if the insulin-producing cells of the pancreas are
damaged.
What Causes Pancreatitis?
In most cases, acute pancreatitis is caused
by gallstones or heavy alcohol use. Other causes
include medications, autoimmune disease, infections,
trauma, metabolic disorders, and surgery. In up to 15% of
people with acute pancreatitis, the cause is unknown.
In about 70% of people, chronic pancreatitis is caused by
long-time alcohol use. Other causes include gallstones,
hereditary disorders of the pancreas, cystic fibrosis,
high triglycerides, and certain medicines. In about 20% to
30% of cases, the cause of chronic pancreatitis is
unknown.
What Are the Risk Factors for Pancreatitis?
Pancreatitis can happen to anyone, but it is more common
in people with certain risk factors.
Risk factors of acute pancreatitis include:
•Gallstones
•Heavy alcohol drinking
Acute pancreatitis may be the first sign of gallstones.
Gallstones can block the pancreatic duct, which can
cause acute pancreatitis.
Risk factors for chronic pancreatitis include:
•Heavy alcohol drinking for a long time
•Certain hereditary conditions, such as cystic fibrosis
•Gallstones
•Conditions such as high triglycerides and lupus
How Is Pancreatitis Diagnosed?
To diagnose acute pancreatitis, doctors measure levels in
the blood of two digestive enzymes, amylase and lipase.
High levels of these two enzymes strongly suggest acute
pancreatitis.
Doctors may also use other tests, such as:
•Pancreatic function test to find out if the pancreas is
making the right amounts of digestive enzymes
•Glucose tolerance test to measure damage to the cells in
the pancreas that make insulin
•Ultrasound, CT scan, and MRI, which make images of
the pancreas so that problems may be seen
•ERCP to look at the pancreatic and bile ducts using X-
rays
•Biopsy, in which a needle is inserted into the pancreas to
remove a small tissue sample for study
In more advanced stages of the disease, doctors may
use blood, urine, and stool tests to confirm the diagnosis.
How Is Pancreatitis Treated?
Treatment for acute pancreatitis
People with acute pancreatitis are typically treated with IV
fluids and pain medications in the hospital. In some
patients, the pancreatitis can be severe and they may
need to be admitted to an intensive care unit (ICU). In the
ICU, the patient is closely watched because pancreatitis
can damage the heart, lungs, or kidneys. Some cases of
severe pancreatitis can result in death of pancreatic
tissue. In these cases, surgery may be necessary to
remove the dead or damaged tissue if an infection
develops.
Treatment for chronic pancreatitis
Chronic pancreatitis can be difficult to treat. Doctors will
try to relieve the patient's pain and improve
the nutrition problems. Patients are generally given
pancreatic enzymes and may need insulin. A low-fat diet
may also help.
Figure 5. Causes of Pain in chronic pancreatitis.This figure shows the
various factors that may contribute to the pain of chronic pancreatitis.
Obstruction of the pancreatic duct by strictures or stones may cause increased
pressures within the duct. Ischemia of the pancreas occurs as a result of chronic
inflammation, which can cause pain. Obstruction of the duodenum or common
bile duct may worsen acute episodes. Inflammation of the nerves also causes
pain. Various treatment modalities are targeted to these different factors.
Adapted from Gorelick F, Pandol SJ, Topazian M. Pancreatic physiology,
pathophysiology, acute and chronic pancreatitis. Gastrointestinal Teaching
Project, American Gastroenterological Association. 2003.
Hereditary Pancreatitis
In some cases, pancreatitis is related to inherited
abnormalities of the pancreas or intestine. Acute recurrent
attacks of pancreatitis early in life (under age 30) can
often progress to chronic pancreatitis. The most common
inherited disorder that leads to chronic pancreatitis is
cystic fibrosis. Recent research demonstrates genetic
testing can be a valuable tool in identifying patients
predisposed to hereditary pancreatitis.
As in chronic pancreatitis, hereditary pancreatitis is a
progressive disease with a high risk of permanent
problems. Patients with these disorders may have chronic
pain, diarrhea, malnutrition, or diabetes. Treatment
focuses on pain control and pancreatic enzyme
replacement.
by the pancreas into the pancreatic duct.
Endocrine pancreatic tumors, also known as islet cell tumors, are usually less
aggressive than exocrine tumors and are more rare. The majority of them
are benign tumors that do not metastasize, although some are malignant. Islet cell
tumors include gastrinomas, glucagonomas, and insulinomas and occur in the
pancreatic cells that make the hormones gastrin, glucagon, and insulin, respectively.
They often are detected earlier than exocrine cancers because they cause the signs
and symptoms of excessive amounts of insulin and glucagon. Simple blood tests for
these hormones are used to measure hormone levels in the blood and confirm if the
levels are in fact elevated.
Because they are more common and aggressive, the remainder of this discussion
focuses on exocrine cancers. Unfortunately, these cancers are hard to detect at an
early stage. Since the pancreas is deep in the body, developing tumors cannot usually
be seen or felt during a physical examination. By the time symptoms develop, the
cancer has often spread throughout the pancreas and beyond.
According to the American Cancer Society, rates of pancreatic cancer have been
slowly increasing over the past 10 years. In 2014, a projected 46,420 Americans will
be diagnosed with pancreatic cancer and an estimated 39,590 will die from it.
Pancreatic cancer is the fourth leading cause of cancer death in the United States,
primarily because only about 10% of the cancers are still contained within the
pancreas at the time of diagnosis.
Risk Factors
The main risk factor for pancreatic cancer is smoking.
About 30% of pancreatic cancers are thought to be a
direct result of cigarette smoking. Other risk factors
include:
•Age (most often seen in people older than 60)
•Whether a person is a male or female (men are 30%
more likely to develop pancreatic cancer than women)
•Chronic pancreatitis
•Diet (a diet high in meats and fats appears to increase
risk)
•Diabetes mellitus
•Exposure to industrial chemicals, such as certain
pesticides and petroleum products
•Family history (an inherited tendency may be a factor in
5% to 10% of cases)
It should be noted that most people who have known risk
factors do not get pancreatic cancer, and many who do
get pancreatic cancer have none of these risk factors
Signs and Symptoms
Early symptoms of pancreatic cancer are often either
absent or subtle. They include:
•Abdominal and/or back pain
•Pruritus
•Nausea
•Loss of appetite
•Unexplained weight loss
•Jaundice

Since these symptoms are seen in other conditions

besides cancer, they may be ignored or missed in the
early stages. By the time chronic pain, nausea,
vomiting, malabsorption, and, in some rare instances,
problems with blood sugar control surface and are
recognized, the pancreatic cancer has usually spread.
intended to treat pancreatic cancer include the Whipple procedure, distal
pancreatectomy, and total pancreatectomy. For more on these, see the Johns Hopkins
Kimmel Cancer Center's page on Pancreatic Cancer Surgery.
Radiation and chemotherapy may be used to treat pancreatic cancer and typically are
necessary because often tiny, undetectable amounts of a tumor will have spread by the
time a surgery is done. Regrettably, pancreatic cancer does not respond well to current
treatments. Gemcitabine and 5-fluorouracil (5-FU) are the most commonly used
chemotherapy agents. They may be used alone or in combination with other drugs.
Research into new treatment options known as "targeted therapies" is an active and
ongoing field. Attempts to develop new drugs that have specific targets are meant to
have fewer side effects than current chemotherapy drugs. Examples include pancreatic
cancer growth factor inhibitors, anti-angiogenesis factors that block new blood vessels
essential for cancer growth, and drugs that target substances involved in the spread of
pancreatic cancer.
For those with recurring or inoperable pancreatic cancer, palliative (comfort-oriented)
care is the primary priority. Radiation, chemotherapy, and surgery may be used to help
relieve pain. Surgery may also be performed to cut nerves to help relieve pain that is
resistant to other measures.
People with inoperable pancreatic cancer may want to consider enrollment in clinical
trials that assess new treatments. Learn more about clinical trials at the National
Cancer Institute website
abnormalities in the structure of the pancreas due to the
presence of a tumor. If abnormal areas are identified, a
biopsy can be performed.
•Magnetic resonance cholangiopancreatography (MRCP):
a type of magnetic resonance imaging (MRI) used to see
the pancreas, its ducts, and the bile ducts more clearly;
often used before or instead of ERCP because it is faster
and noninvasive; also useful in
distinguishing pancreatitis from pancreatic cancer

For more information on imaging studies,

see RadiologyInfo.org.
Laboratory tests that may show abnormal results but are
not diagnostic of pancreatic cancer include the following:
•Comprehensive metabolic panel: a group of tests that
may be used to evaluate liver and kidney function and to
determine why someone is jaundiced
•CA 19-9 (Cancer antigen 19-9): a tumor marker for
pancreatic cancer; it may be used to distinguish
pancreatic cancer from other cancers or to monitor for
cancer recurrence. It is not currently useful for detection or
diagnosis by itself because non-cancerous conditions can
cause elevated CA 19-9 levels. Recent research,
however, suggests that it may be useful for early detection
of pancreatic cancer when combined with a promising
Types of pancreatic cancer
Exocrine cancers are by far the most common type of pancreas cancer. If you
are told you have pancreatic cancer, it's most likely an exocrine pancreatic
cancer.
Pancreatic adenocarcinoma: About 95% of cancers of the exocrine pancreas
are adenocarcinomas. These cancers usually start in the ducts of the pancreas.
Less often, they develop from the cells that make the pancreatic enzymes, in
which case they are called acinar cell carcinomas.
Less common types of exocrine cancer: Other, less common exocrine
cancers include adenosquamous carcinomas, squamous cell carcinomas,
signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated
carcinomas with giant cells.
Ampullary cancer (carcinoma of the ampulla of Vater): This cancer starts in
the ampulla of Vater, which is where the bile duct and pancreatic duct come
together and empty into the small intestine. Ampullary cancers aren’t technically
pancreatic cancers, but they are included here because they are treated much
the same.
Ampullary cancers often block the bile duct while they're still small and have not
spread far. This blockage causes bile to build up in the body, which leads to
yellowing of the skin and eyes (jaundice). Because of this, these cancers are
usually found earlier than most pancreatic cancers, and they usually have a
better prognosis (outlook).
as precancers). Because people are getting imaging tests such as CT
scans more often than in the past (for a number of reasons), these types
of pancreatic growths are now being found more often.
Serous cystic neoplasms (SCNs) (also known as serous cystadenomas)
are tumors that have sacs (cysts) filled with fluid. SCNs are almost always
benign, and most don’t need to be treated unless they grow large or cause
symptoms.
Mucinous cystic neoplasms (MCNs) (also known as mucinous
cystadenomas) are slow-growing tumors that have cysts filled with a jelly-
like substance called mucin. These tumors almost always occur in women.
While they are not cancer, some of them can progress to cancer over time
if not treated, so these tumors are typically removed with surgery.
Intraductal papillary mucinous neoplasms (IPMNs) are benign tumors
that grow in the pancreatic ducts. Like MCNs, these tumors make mucin,
and over time they sometimes become cancer if not treated. Some IPMNs
can just be followed closely over time, but some might need to be
removed with surgery if they have certain features, such as if they are in
the main pancreatic duct.
Solid pseudopapillary neoplasms (SPNs) are rare, slow-growing tumors
that almost always develop in young women. Even though these tumors
tend to grow slowly, they can sometimes spread to other parts of the body,
so they are best treated with surgery. The outlook for people with these
tumors is usually very good.
What is pancreatic insufficiency?
Pancreatic insufficiency is the inability of
the exocrine pancreas to produce and/or transport enough
digestive enzymes to break down food in the intestine and
facilitate absorption of nutrients. It typically occurs as a
result of progressive pancreatic damage that may be
caused by recurrent acute pancreatitis or
by chronic pancreatitis due to a variety of conditions.
In children, it is most frequently associated with cystic
fibrosis (CF) or Shwachman-Diamond Syndrome (SDS).
SDS is the second most common cause of inherited
pancreatic insufficiency, after CF. All those with SDS have
some degree of pancreatic insufficiency beginning at
infancy.
Insufficiency can also be associated with type 1, type 2, or
autoimmune diabetes. It is less frequently but sometimes
associated with pancreatic cancer. Other causes of
insufficiency may include celiac disease, Crohn disease,
autoimmune pancreatitis (immunoglobulin G4-related
disease), Zollinger-Ellison syndrome, and some surgical
procedures that can lead to a decrease in gastrointestinal
or pancreatic function.
Signs and Symptoms
Pancreatic insufficiency usually presents
with signs and symptoms of malabsorption, malnutrition,
vitamin deficiencies, abdominal cramps, and weight loss
(or, in children, an inability to gain weight) and is often
associated with steatorrhea (loose, fatty, foul-smelling
stools). Diabetes may also be present in adults with
pancreatic insufficiency.
Laboratory evaluation is often necessary to diagnose
pancreatic insufficiency because symptoms may not be
evident or may be similar to those of other gastrointestinal
disorders
place a suspension of stool onto a glass slide, add a fat stain, and observe the number and size
of fat globules that are present. A more accurate assessment of fecal fat requires a timed stool
collection, typically spanning 72 hours, and a dietary sheet to help calculate the total fat intake
during the collection period. This test is generally thought of as unreliable because it is difficult to
achieve proper control of the diet, challenging to ensure complete sample collection, and there is
significant test variation.
•13C-mixed triglyceride breath test is a novel test that is a noninvasive, reliable method of
diagnosing moderate pancreatic insufficiency, but it is not widely used and not commonly
available. The test may also be used to evaluate the efficacy of enzyme therapy on fat digestion
in people with insufficiency.

Non-laboratory tests used in diagnosing pancreatic insufficiency

•Endoscopic retrograde cholangiopancreatography (ERCP): a test that uses a flexible scope
inserted through the mouth and threaded through the esophagus to see and document damage
to the pancreas and/or bile ducts.
•Magnetic resonance cholangiopancreatography (MRCP): a type of magnetic resonance imaging
(MRI) used to examine the pancreas and bile ducts.
•Secretin test (not widely available): a tube is positioned in the duodenum to collect pancreatic
secretions stimulated by intravenous (IV)secretin. Secretin is a hormone that causes the
pancreas to release fluid containing digestive enzymes. The amount of certain enzymes and
bicarbonate in this fluid is measured and compared to normal values.
decreased enzyme production and to aid digestion. The primary purpose of this therapy is
to ensure proper nutritional status. The therapy involves taking porcine (pig)-derived
pancreatic enzyme products (PEPs), which are similar to human pancreatic enzymes, to
supplement normal pancreatic function. The enzymes lipase, amylase, and protease
(important pancreatic enzymes) are contained in the PEP mixture and aid in digesting fats,
carbohydrates and proteins.
People with pancreatic insufficiency may also be given vitamin supplements, especially the
fat-soluble vitamins A, D, E, and K, since absorption of fats (and therefore absorption of the
aforementioned vitamins) is frequently impaired. They may be put on a diet low in fat and
high in protein and calories to help gain and maintain weight. Limiting of alcohol intake may
also be required because alcohol can cause further pancreatic damage.
In Shwachman-Diamond Syndrome (SDS), unlike in cystic fibrosis, secretion of pancreatic
lipase (an enzyme that digests fats) often increases with age. The reasons for this are not
yet known, but about 50% of children with SDS will experience improvements in pancreatic
function and fat absorption as they get older and will no longer require enzyme replacement
therapy.
Rare Syndromes
Congenital Abnormalities
Annular Pancreas – is usually a band of pancreatic
tissue that completely encircles the second portion
of the duodenum, and may cause duodenal
stenosis. Annular pancreas is a rare finding
(~3/20,000 autopsies). Theoretically annular
pancreas may occur embryonically when the ventral
bud becomes fixed and fails to rotate. This
hypothesis is supported by the usual finding of the
duct encircling the pancreas from anterior to
posterior around the right side to join the common
bile duct. Other variants have also been
seen. Annular pancreas is frequently observed in
conjunction with other congenital defects including
intestinal malrotation, cardiac defects, Meckel’s
diverticuli, imperforate anus, and spinal defects. It
is common in Down’s syndrome. The classic
presentation is a vomiting infant with the
characteristic “double bubble” sign on radiographic
imaging.
Ectopic pancreatic tissue–may occur from
displacement of small amounts of pancreas during
embryonic development, resulting in the formation
of a nodule which is independent of the
pancreas. Ectopic pancreatic tissue, or pancreatic
rest, is relatively common on careful histologic
examination (1-14% of autopsy cases), but typically
it is not of clinical significance. Ectopic tissue is
usually seen in the stomach, duodenum, and
jejunum, but foci of pancreatic tissue have been
reported throughout the gastrointestinal tract. It is
rare for ectopic pancreatic tissue to cause symptoms
or require treatment, but, infrequently, pancreatitis
or pancreatic cancer may develop in the tissue.
Congenital Pancreatic Insufficiency Syndromes
These two symptoms represent failure of the acinar
cells, whereas cystic fibrosis affects the ductal cells.
Shwachman-Diamond Syndrome – is an autosomal
recessive disorder characterized by pancreatic
insufficiency, cyclic neutropenia, metaphyseal
dysostosis, and growth retardation (1). Sweat
chloride is normal. The gene defect is near the
centromere of chromosome 7 and involves a newly
discovered gene, the Shwachman-Bodian-Diamond
Syndrome gene (SBDS) (2), which appears to be
involved with RNA processing.
Johanson-Blizzard Syndrome – is an autosomal
recessive disorder characterized by pancreatic
insufficiency, nasal alar hypoplasia, tooth
abnormalities, short stature, psychomotor
retardation, congenital deafness and ectodermal
scalp defects. Fewer than 40 cases have been
reported. The gene appears to be associated with
ubiquination of proteins.
Other symptoms that may accompany an enlarged
pancreas include:
•Nausea and vomiting.
•Diarrhea or oily stools.
•Weight loss.
•Fever.
•Rapid pulse.
•Jaundice.
Hemosuccus pancreaticus[edit]
Hemosuccus pancreaticus, also known
as pseudohematobilia or Wirsungorrhage, is a rare cause
of hemorrhage in the gastrointestinal tract. It is caused by
a bleeding source in the pancreas, pancreatic duct, or
structures adjacent to the pancreas, such as the splenic
artery, that bleed into the pancreatic duct. Patients with
hemosuccus may develop symptoms of gastrointestinal
hemorrhage, such as blood in the stools, maroon stools,
or melena. They may also develop abdominal pain.
Hemosuccus pancreaticus is associated
with pancreatitis, pancreatic cancer and aneurysms of
the splenic artery. Angiography may be used to diagnose
hemosuccus pancreaticus, where the celiac axis is
injected to determine the blood vessel that is bleeding.
Concomitant embolization of the end vessel may
terminate the hemorrhage. Alternatively, a distal
pancreatectomy may be required to stop the hemorrhage.
See also
Pancreatic serous cystadenoma a benign tumour of
pancreas. It is usually found in the tail of the
pancreas,[1] and may be associated with von Hippel-
Lindau syndrome.[2]
In contrast to some of the other cyst-forming tumors of the
pancreas (such as the intraductal papillary mucinous
neoplasm and the mucinous cystic neoplasm), serous
cystic neoplasms are almost always entirely benign. There
are some exceptions; rare case reports have described
isolated malignant serous cystadenocarcinomas.[3] In
addition, serous cystic neoplasms slowly grow, and if they
grow large enough they can press on adjacent organs and
cause symptoms.
A solid pseudopapillary tumour is a low-grade
malignant neoplasm of
the pancreas of papillary architecture that typically afflicts
young women.[1]
medical history, physical examination, and typically a
blood test (amylase or lipase) for digestive enzymes of the
pancreas. Blood amylase or lipase levels are typically
elevated 3 times the normal level during acute
pancreatitis. In some cases when the blood tests are not
elevated and the diagnosis is still in question, abdominal
imaging, such as a computed tomography (CT) scan,
might be performed.
Testing
After diagnosis is confirmed, certain imaging tests might be performed during
hospitalization or after to help identify the cause. Such tests include:
•Transabdominal ultrasound
•This is commonly performed during hospitalization to specifically evaluate the
gallbladder for stones because gallstones are the most common cause of acute
pancreatitis. Ultrasound uses sound waves that bounce off the pancreas,
gallbladder, liver, and other organs, and their echoes generate electrical impulses
that create an image—called a sonogram—on a video monitor. If gallstones are
causing inflammation, the sound waves will also bounce off of them, showing
their location.
•Endoscopic ultrasound (EUS)
Endoscopic ultrasound (EUS)
This test is not commonly required during acute
pancreatitis. Compared to transabdominal ultrasound, it is
relatively more invasive, in that a physician passes a
flexible thin tube down into the stomach. A camera and
ultrasound probe are attached to the end of the tube,
which enable the physician to look at images of the
gallbladder, pancreas, and liver. The images are more
sensitive than those of transabdominal ultrasound in
detecting small stones in the gallbladder and bile ducts
that may have been missed. It can also visualize the
pancreas for abnormalities. To read more about this,
please click here.
Magnetic resonance cholangiopancreatography
(MRCP)
MRCP uses magnetic resonance imaging (MRI), a
noninvasive procedure that produces cross-section
images of parts of the body. After being lightly sedated,
the patient lies in a cylinder-like tube. The technician
injects dye into the patient’s veins, which helps show the
pancreas, gallbladder, and pancreatic and bile ducts. This
is another sensitive test for evaluating the gallbladder, bile
ducts, and pancreas for causes of acute pancreatitis.
Computerized tomography (CT)
A CT scan is a noninvasive radiograph (x-ray) that
produces 3-dimensional images of parts of the body. The
patient lies on a table that slides into a donut-shaped
machine. Typically not performed initially for an episode of
acute pancreatitis, it may be performed when a diagnosis
is uncertain or several days into hospitalization to evaluate
the extent of pancreatic damage when a patient is not
recovering as quickly as expected.
Do Drugs Hurt the Pancreas?
Certain drugs can damage the pancreas. The most notable drug
is alcohol; however, other drugs may cause harm, as well.
Alcohol
One of the most common causes of acute pancreatitis is alcohol
abuse. Alcohol can cause serious and potentially long-term harm
to your pancreas. It is common for people who drink often
and/or heavily to experience episodes of acute pancreatitis.
Repeated episodes of pancreatitis can damage the organ
permanently and cause chronic pancreatitis. Chronic pancreatitis
is most often caused by years of alcohol abuse. Alcohol-related
pancreatitis is more common among men than women.
Other drugs
Although acute pancreatitis is caused by a variety of things,
including infection, ethanol abuse, and genetics, pancreatitis
caused by medication is less common. In fact, it only accounts
for roughly 2% of all cases of pancreatitis cases (Trivedi &
Pitchumoni, 2005).
Do Drugs Hurt the Pancreas?
Certain drugs can damage the pancreas. The most
notable drug is alcohol; however, other drugs may
cause harm, as well.
Alcohol
One of the most common causes of acute
pancreatitis is alcohol abuse. Alcohol can cause
serious and potentially long-term harm to your
pancreas. It is common for people who drink often
and/or heavily to experience episodes
of acute pancreatitis.
Repeated episodes of pancreatitis can damage the
organ permanently and cause chronic pancreatitis.
Chronic pancreatitis is most often caused by years of
alcohol abuse. Alcohol-related pancreatitis is more
common among men than women.
Other drugs
Although acute pancreatitis is caused by a variety of
things, including infection, ethanol abuse, and
genetics, pancreatitis caused by medication is less
common. In fact, it only accounts for roughly 2% of
all cases of pancreatitis cases (Trivedi & Pitchumoni,
2005).
Your doctor may prescribe or provide the following:
Medicines and vitamins. Your doctor may give you
enzyme pills to help with digestion, or vitamins A, D, E,
and K if you have malabsorption. He or she may also give
you vitamin B-12 shots if you need them.
Treatment for diabetes. Chronic pancreatitis may
cause diabetes. If you get diabetes, your doctor and
health care team will work with you to create an eating
plan and a routine of medicine, blood glucose monitoring,
and regular checkups.
Surgery. Your doctor may recommend surgery to relieve
pressure or blockage in your pancreatic duct, or to remove
a damaged or infected part of your pancreas. Surgery is
done in a hospital, where you may have to stay a few
days.
In patients who do not get better with other treatments,
surgeons may perform surgery to remove your whole
pancreas, followed by islet auto-transplantation. Islets are
groups of cells in your pancreas that make hormones,
including insulin. After removing your pancreas, doctors
will take islets from your pancreas and transplant them
into your liver. The islets will begin to make hormones and
release them into your bloodstream.
Maintaining a healthy lifestyle and a healthy weight—or
losing weight if needed—can help to
•make your pancreas work better
•lower your chance of getting gallstones, a leading cause
of pancreatitis
•prevent obesity—a risk factor for pancreatitis
•prevent diabetes—a risk factor for pancreatitis