What is pancreatitis ?
Pancreatitis is the medical term for inflammation of the pancreas (pancreatic). The disease is caused by damage to the tissue by its own digestive juice.
There are two forms of pancreatitis: acute pancreatitis and chronic pancreatitis. Both are serious conditions that may be associated with pain. One speaks of a chronic pancreatitis, if the acute situation lasts longer than six months.
Pancreatitis causes
Acute pancreatitis
The main causes of acute pancreatitis are gallstones (55%), alcoholism (25%), trauma, hypercalcemia (too much calcium in the blood), hyperlipidemia (excess of lipids in blood), hereditary factors, hemochromatosis (iron overload disease), ischemia and unknown reasons. Another possibility to excessive irritation of the pancreas can be by an ERCP-examination and occasionally at the same places of the stent in the bile ducts in biliary tumors.
Chronic pancreatitis
Is often caused by alcohol, but can also be caused by a metabolic disorder (hyperlipoproteinemia, hypercalcemia), genetic predisposition (cystic fibrosis), trauma, an obstruction (jam) of the papilla of Vater as a result of a constriction or a tumor.
Pancreatitis symptoms
Chronic pancreatitis may be asymptomatic or abdominal pain, malabsorption, fever or give diabetes mellitus.
The pain is usually deeply felt in the upper abdomen to the back, in height varying from day to day. At an early stage of the disease, the pain can occur episodically: be present for days or weeks and then disappear for several months before returning.
Attacks of acute pancreatitis can occur on top of chronic pain development.
Since the islets of Langerhans situated in the pancreas, can be used as a symptom diabetes mellitus type-1 action.
Ultimately, there peritonitis and shock action
Chronic And Acute Pancreatitis Treatment
Acute pancreatitis treatment:
-Initially: large amount of fluid infused and non per os (nothing by mouth).
-As the cure lasts more than 2 days: gavage. Tube feeding is better than the use of so-called parenteral nutrition
-Routine use of antibiotics is not useful
-If infection of dead pancreatic tissue (necrosis) has occurred this should be surgically removed, preferably by first draining a tube through the radiologist placed through the skin and if not enough work keyhole surgery (VARD surgery). This is only done in a few Dutch hospitals. Coordinate data is carried by the Netherlands Pancreatitis Study Group.
Chronic pancreatitis treatment:
-Pain relief via oral intake of painkillers, the (temporary) 'incineration' -by alcohol nerves surrounding the pancreas, an implanted morphine pump.
-Pharmalogical by use of antacids, digestive enzymes in the food and fat restriction in the diet, and (if necessary) analgesics;
-If diabetes (or diabetes mellitus) occurred due to pancreatitis treated with insulin
-By means of the endoscopic placement of a tube or stent in the duct of the pancreas in order to obtain better run-off of the pancreatic juice
-Operatively with removal of affected parts and in order to obtain a better flow of the pancreatic juice
-Operatively by a total pancreasresectie