Pancreatitis are acute inflammation of the pancreas. There are acute and chronic forms of the disease. This section discusses the acute pancreatitis. This is defined as a sudden inflammation of the pancreas, which may occur once or several times.
The cause of acute pancreatitis is that the digestive enzymes produced by the pancreas are already effective in the pancreas itself (rather than the gut) and attacking the tissue. It is practically self digestion of the body. Most commonly, acute pancreatitis is caused by gallstones.
The excretory duct of gallbladder (ductus choledochus) joins together with the excretory duct of the pancreas (ductus pancreaticus) into the duodenum (duodenal). If gallstones are going down, they clog the Canal so that there is also a backlog of pancreatic secretion. Because where the bile also back can rise up, also a jaundice (jaundice) is possible.
Another common cause is the abuse of alcohol. Injury to the pancreas, infection (mumps and other diseases), errors in the fat metabolism or mineral balance, medication, vascular disease, birth defects or mechanical obstacles (tumor or stenosis of the mouth, scars, Ascaris) are rare.
The back pressure of fluid activates the enzymes that would normally secreted into the intestine in the wrong place. These enzymes to break down food components. The premature activation means that the pancreas cells are angedaut. Also blood vessels can be attacked and may cause bleeding. The body is lost through these processes much protein-rich fluid and blood, and can cause a State of shock.
In addition, the activated enzymes in the bloodstream can transgress. They are distributed in the body and can cause damage to other organs. An irritation of the colon up to the paralytic ileus and a peritonitis arising in the abdominal cavity. In the pancreas itself, it comes to a tissue edema or necrosis.
The oedematous form is most common with 60 percent. In 30 percent of cases there are partial necrosis, in 10% of cases of complete necrosis. The more the necrosis are pronounced, the more complications occur and the higher the risk of pancreatitis is to die. After the acute phase, the cause of pancreatitis must be eliminated to prevent renewed inflammation (E.g. removal of the gallbladder, if the cause was gall stones).
The acute pancreatitis presents itself as «acute stomach»: suddenly occurring severe pain in the upper abdomen (often belt-shaped with broadcasting in the back), vomiting, nausea, flatulence, flushed face. Heart palpitations, accelerated heart rate, blood pressure and weakness are signs of incipient shock. The patients are suffering, the belly is bulging elastic and gallstones. At simultaneous ileus, intestinal noises are reduced. The conjunctiva of the eye can be yellowish discoloration as an expression of an accompanying jaundice. The pancreatic enzymes are elevated in the blood serum alpha-amylase and lipase.
Ultrasound: The pancreas is swollen; any gallstones are visible. If the ultrasound is not revealing enough, you can perform a CT scan with contrast. To exclude other possible causes of an acute abdomen, each creates an X-ray of chest and abdomen. Detection of bile stones an ERC occurs at an early stage. The course is harder, ever more necrosis and complications occur.
The edematous form without complications, the mortality rate is 5 percent. Partial necrosis and one or two complications, the mortality rate is already between 25 and 50 percent. With total necrosis and three until four complications the mortality rate rises to 80 to 100 percent. Survived the acute pancreatitis and the triggering cause removed, the disease heals normally. However, scars and cysts can remain and limit the function of the organ.
Possible complications of acute pancreatitis are numerous and feared:
- Shock due to loss of fluids
- Acute renal failure
- Acute respiratory failure
- Formation of abscess
- Necrosis of adjacent organs
- Bleeding in the gastrointestinal tract (blood, flowing from the pancreas in the intestine; Stress bleeding in the stomach)
The treatment of acute pancreatitis must be in the hospital during heavy history even in the ICU because the patients need to be monitored carefully. The treatment is bed rest and ban on food and fluid intake. With vomiting, ileus, and complications, a feeding tube is placed. Patients receive antibiotics to painkillers, if necessary. With heavy gradients, an operation may be necessary to remove dead tissue.
When a patient with acute pancreatitis should eat again, is different. It starts slowly with tea and biscuits, followed by light fare (no fat, coffee, alcohol).