Pancreatitis (cont.)
What are the symptoms of acute pancreatitis?
Acute pancreatitis usually begins with pain in the upper abdomen
that may last for a few days. The pain may be severe and may become
constant-just in the abdomen-or it may reach to the back and other areas. It may
be sudden and intense or begin as a mild pain that gets worse when food is
eaten. Someone with acute pancreatitis often looks and feels very sick. Other
symptoms may include
- swollen and tender abdomen
Severe cases may
cause dehydration and low blood pressure. The heart, lungs, or kidneys may fail.
If bleeding occurs in the pancreas, shock and sometimes even death follow.
How is acute pancreatitis diagnosed?
Besides asking about a person's medical history and doing a
physical exam, a doctor will order a blood test to diagnose acute pancreatitis.
During acute attacks, the blood contains at least three times more amylase and
lipase than usual. Amylase and lipase are digestive enzymes formed in the
pancreas. Changes may also occur in blood levels of glucose, calcium, magnesium,
sodium, potassium, and bicarbonate. After the pancreas improves, these levels
usually return to normal.
A doctor may also order an abdominal ultrasound to look for gallstones and a
CAT (computerized axial tomography) scan to look for inflammation or destruction
of the pancreas. CAT scans are also useful in locating pseudocysts.
How is acute pancreatitis treated?
Treatment depends on the severity of the attack. If no kidney or
lung complications occur, acute pancreatitis usually improves on its own.
Treatment, in general, is designed to support vital bodily functions and prevent
complications. A hospital stay will be necessary so that fluids can be replaced
intravenously.
If pancreatic pseudocysts occur and are considered large enough to interfere
with the pancreas's healing, your doctor may drain or surgically remove them.
Unless the pancreatic duct or bile duct is blocked by gallstones, an acute
attack usually lasts only a few days. In severe cases, a person may require
intravenous feeding for 3 to 6 weeks while the pancreas slowly heals. This
process is called total parenteral nutrition. However, for mild cases of the
disease, total parenteral nutrition offers no benefit.
Before leaving the hospital, a person will be advised not to drink alcohol
and not to eat large meals. After all signs of acute pancreatitis are gone, the
doctor will try to decide what caused it in order to prevent future attacks. In
some people, the cause of the attack is clear, but in others, more tests are
needed.
Complications
Acute pancreatitis can cause breathing problems. Many people
develop hypoxia, which means that cells and tissues are not receiving enough
oxygen. Doctors treat hypoxia by giving oxygen through a face mask. Despite
receiving oxygen, some people still experience lung failure and require a
ventilator.
Sometimes a person cannot stop vomiting and needs to have a tube placed in
the stomach to remove fluid and air. In mild cases, a person may not eat for 3
or 4 days and instead may receive fluids and pain relievers through an
intravenous line.
If an infection develops, the doctor may prescribe antibiotics. Surgery may
be needed for extensive infections. Surgery may also be necessary to find the
source of bleeding, to rule out problems that resemble pancreatitis, or to
remove severely damaged pancreatic tissue.
Acute pancreatitis can sometimes cause kidney failure. If your kidneys fail,
you will need dialysis to help your kidneys remove wastes from your blood.
Next: What about gallstones and pancreatitis? »
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