Acute pancreatitis

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What is it about ?

The pancreas is a digestive gland that is located in the upper abdomen, behind the stomach. It has two functions:

  • Produce and secrete hormones in the blood, such as insulin and glucagon to regulate the level of sugar in the blood (blood sugar) (endocrine secretion);
  • Produce and secrete enzymes in the small intestine for the digestion of sugars, fats and proteins (exocrine secretion).

Acute pancreatitis is sudden inflammation of the pancreas. The disease is characterized by sharp pain in the upper abdomen.

The causes

The main causes (7 times out of 10) of acute inflammation of the pancreas are:

Rather rare causes are:

The evolution is moderate in 8 out of 10 people; complications (serious) occur in 2 in 10 people. About 1 in 10 affected people die.

Persistent inflammation of the pancreas is called a chronic pancreatitis.

What is its frequency?

Acute pancreatitis affects around 16 in 100,000 people1. The number of cases increases with age.

How to recognize it?

Symptoms

The main complaint is the rapid onset a sharp pain in the upper abdomen, which radiates in the back. Pain is associated with nausea and vomiting.

  • If you have some gallstones, you can make a biliary crisis within a few hours of pancreatitis. In a biliary crisis, the pain usually goes away after 6 to 8 hours, while in the case of pancreatitis, it can last for several days.
  • In case of excessive consumption of alcohol, inflammation usually starts 1 to 3 days after a heavy drinking episode or if you suddenly stop taking alcohol consumption.
Necrosis of pancreatic tissue

The death (necrosis) of pancreatic tissue is a particularly dreaded complication. Bacteria easily contaminate dead tissue. In this case, the following symptoms may occur:

  • Fever ;
  • Increased heart rate;
  • Confusion ;
  • State of shock with very significant drop in blood pressure;
  • Deficiency in the functioning of the intestines (noticeable in the swollen and tense stomach);
  • Blood effusions from the flanks and around the navel.

What can you do ?

If you feel a strong abdominal pain that you cannot explain right away, see the doctor as soon as possible.

Always drink alcohol in moderation. If you have ever had an episode of pancreatitis following the alcohol consumption, it is better not to drink at all.

How is the diagnosis made?

If the doctor suspects pancreatitis, he will immediately do test your blood and urine. It will also give you a ultrasound. If these analyzes and examinations confirm the diagnosis, the doctor will refer you to the emergency department.

What can your doctor do?

All attacks of pancreatitis, however mild, are treated in hospital because life-threatening complications can occur.

Adjuvant therapy in hospital
  • The rehydration is essential; even mild pancreatitis causes dehydration. You are given fluids and nutrients as an infusion.
  • If the vomiting are severe, it will be necessary to place a gastric tube.
  • In case of infection, administer antibiotics.
  • You receive treatment Pain killer.

Drugs that slow pancreatic activity have no demonstrated effect, neither on complications nor on the risk of death. They are only used in people with severe pancreatitis who need to have an operation to remove the infected tissue.

Remove gallstones and gallbladder

If gallstones are the cause of pancreatitis, it will be necessary to remove laparoscopic gallbladder (exploratory surgery). This is done directly during hospitalization or it can be postponed until you feel better.

If the gallstones are still in the excretory duct of the gallbladder or if the bile ducts are inflamed, the gallstones will have to be removed the same day. To do this, we practice a endoscopic retrograde cholangiopancreatography (ERCP)): a small camera is inserted through the mouth into the duodenum which allows the gallstones to be extracted.

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