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Pancreatitis is an inflammatory condition of the pancreas. It usually presents as an acute illness requiring hospital admission. It is diagnosed with a blood test or abdominal CT scan and is managed by general surgeons. The condition can be considered as a burn within the abdominal cavity and treated accordingly.
The cause of pancreatitis is western society is almost exclusively as a result of gallstone disease or from the consumption of excessive amounts of alcohol. Neither mechanism of injury to the pancreas is entirely understood. More rarely medications can induce the condition.
- Abdominal pain (usually upper abdominal and left sided)
- High temperature
- Circulatory Failure and Shock
- Shortness of breath
- Organ failure
The mainstay of treatment for patients with mild to moderate pancreatitis is supportive with intravenous fluids, oxygen, pain relief and occasionally antibiotics. Most patients will settle and improve with this treatment whereupon attention turns to the investigation and treatment or removal of, the causative stimulus to inflammation.
Patients who suffer more severe and often life-threatening pancreatitis require more complex supportive care and observation in an intensive care unit. They may require radiological or even surgical intervention to treat the injury to the pancreas itself or the surrounding organs that have been damaged. Recovery in such cases may take many months
Patients often require an abdominal ultrasound scan to identify gallstones, a CT scan to assess the degree of pancreatic injury and ERCP to remove gallstones which may have become lodged in the biliary duct system.
Abstinence from alcohol consumption and cholecystectomy are necessitated where appropriate. Where the cause for pancreatitis is removed the long term prognosis for the patient is excellent. Where it remains inflammation recurs pancreatic injury continues and ultimately chronic pain, diabetes and disorders of digestion result.