PANCREATITIS

ANATOMY
The pancreas is an elongated, tapered organ located
across the back of the belly, behind the stomach. The
right side of the organ—called the head—is the widest
part of the organ and lies in the curve of the duodenum,
the first division of the small intestine
FUNCTIONS

• Endocrine activity
• performed by the Langerhans islets and involves the
production of hormones such as insulin, proinsulin, amylin,
C-peptide, somatostatin, pancreatic polypeptide (PP), and
glucagon. Insulin helps to lower blood sugar, and glucagon
causes blood sugar to rise. Dąbrowski et al., 2007).
• exocrine activity consists of the
• production of enzymes that are part of the iso-osmotic,
alkaline pancreatic juice
• support the digestion of food in the intestines.
• The intravesical cells produce the enzymatic components
of the juice, which is led into the duodenum through the
pancreatic ducts. In addition, mucus is secreted in the
pancreatic ducts through goblet cells. The composition of
pancreatic juice includes enzymes that digest proteins, fats,
carbohydrates, and nucleic acids, as well as electrolytes and
a small amount of mucus (
PROTEOLYTIC ENZYME

• Enzymes such as trypsin, chymotrypsin, carboxypeptidase,

and elastase belong to the group of proteolytic enzymes
(they digest proteins). Trypsin and chymotrypsin are
secreted in the form of proenzymes: trypsinogen,
chymotrypsinogen.
• The pancreatic lipolytic enzymes are lipase, phospholipase,
and esterase, which digest fats. The glycolytic (carbohydrate
digesting) enzymes are lactase and amylase, which breaks
down starch into maltose, maltotriose, and dextrins.
• Nucleolytic enzymes include ribonuclease and
deoxyribonuclease, which break down nucleic acids into
mono- and oligonucleotides. Food consumption and the
neurohormonal mechanism regulate the secretion of
digestive enzymes. The pancreas secretes pancreatic juice in
a volume of about 1–4 liters per day, and this amount
depends on the food consumed.
• The central nervous system and hormones regulate the
exocrine function of the pancreas. Hormones such as
secretin and cholecystokinin (CCK) are believed to be the
main intestinal hormones that regulate the secretion of
pancreatic digestive enzymes . Secretin is released from
enteroendocrine cells in the small intestine, and CCK is
released from the duodenum and jejunum in the presence of
lipids and proteins from ingested food
ACUTE PANCREATITIS

• Acute pancreatitis occurs unexpectedly without any

previous symptoms.
• Patients typically complain of lower abdominal and middle
back pain,
• vomiting
• dizziness
• increased sweating.
DIAGNOSIS

Blood tests to look for elevated levels of pancreatic enzymes, along with white
blood cells, kidney function and liver enzymes
•Abdominal ultrasound to look for gallstones and pancreas inflammation
•Computerized tomography (CT) scan to look for gallstones and assess the
extent of pancreas inflammation
•Magnetic resonance imaging (MRI) to look for abnormalities in the
gallbladder, pancreas and ducts
•Endoscopic ultrasound to look for inflammation and blockages in the
pancreatic duct or bile duct
• LIVER- alkaline phosphatase,total bilirubin,aspartate
aminotransferase.alanine aminotransferase- gallstones
pancreatitis

• pancreas- amylase and tripase

• kidney function- acute renal failure
MANAGEMENT

• What is the most common treatment for pancreatitis?

• Doctors use ERCP to treat both acute and chronic
pancreatitis. ERCP combines upper gastrointestinal
endoscopy and x-rays to treat narrowing or blockage of a
bile or pancreatic duct. Your gastroenterologist may use
ERCP to remove gallstones blocking the bile or
pancreatic ducts.
• Endoscopic retrograde cholangiopancreatography
• In instances of acute pancreatitis, medications and drips
may be necessary.
• . Diet is necessary . 03).
• What is the immediate management of acute
pancreatitis?
• Medical management of mild acute pancreatitis is
relatively straightforward. The patient is kept NPO (nil per
os—that is, nothing by mouth), and intravenous (IV) fluid
hydration is provided. Analgesics are administered for
pain relief. Antibiotics are generally not indicated.
Lifestyle and home remedies
•Stop drinking alcohol. Even if alcohol was not deemed to be the cause of acute pancreatitis, it is
prudent to stop drinking alcohol while recovering. If you're unable to stop drinking alcohol on your own,
ask your doctor for help. Your doctor can refer you to local programs to
help you stop drinking.
•Stop smoking. If you smoke, quit. If you don't smoke, don't start. If you
can't quit on your own, ask your doctor for help. Medications and
counseling can help you quit smoking.
•Choose a low-fat diet. Choose a diet that limits fat and emphasizes fresh
fruits and vegetables, whole grains, and lean protein.
•Drink more fluids. Pancreatitis can cause dehydration, so drink more
fluids throughout the day. It may help to keep a water bottle or glass of
water with you.