ACUTE PANCREATITIS

ACUTE PANCREATITIS

BIOCHEMISTRY AND PHYSIOLOGY OF PANCREATIC EXOCRINE SECRETION

The pancreas secretes 1500–3000 mL of isosmotic alkaline (pH >8) fluid per day containing about 20 enzymes. The pancreatic secretions provide the enzymes and bicarbonate needed to affect the major digestive activity of the gastrointestinal tract and provide an optimal pH for the function of these enzymes.

COMMON CAUSES

  • Gallstones (including microlithiasis)
  • Alcohol (acute and chronic alcoholism)
  • Hypertriglyceridemia
  • Endoscopic retrograde cholangiopancreatography (ERCP), especially after biliary manometry
  • Drugs (azathioprine, 6-mercaptopurine, sulfonamides, estrogens, tetracycline, valproic acid, anti-HIV medications, 5-aminosalicylic acid [5-ASA])
  • Trauma (especially blunt abdominal trauma)
  • Postoperative (abdominal and nonabdominal operations)
  • Vascular causes and vasculitis (ischemic-hypoperfusion states after cardiac surgery)
  • Connective tissue disorders and thrombotic thrombocytopenic purpura (TTP)
  • Cancer of the pancreas
  • Hypercalcemia
  • Periampullary diverticulum
  • Pancreas divisum
  • Hereditary pancreatitis
  • Cystic fibrosis
  • Renal failure
  • Infections (mumps, coxsackievirus, cytomegalovirus, echovirus, parasites)
  • Occult disease of the biliary tree or pancreatic ducts, especially microlithiasis, biliary sludge
  • Intraductal papillary mucinous neoplasm (IPMN)
  • Autoimmune
  • Idiopathic
  • INSECTICIDE,PESTICIDE,RODENTICIDE,WEEDICIDE

SYMPTOMS

  1. Abdominal Pain -Abdominal pain is the major symptom of acute pancreatitis. Pain may vary from a mild discomfort to severe, constant, and incapacitating distress. Characteristically, the pain, which is steady and boring in character, is located in the epigastrium and periumbilical region, and may radiate to the back, chest, flanks, and lower abdomen.
  2. Nausea, vomiting, and abdominal distention due to gastric and intestinal hypomotility and chemical peritonitis are also frequent complaints.
  3. Distressed and anxious patient.
  4. Low-grade fever
  5. Tachycardia, and hypotension
  6. Shock
  7. Jaundice occurs infrequently; when present, it usually is due to edema of the head of the pancreas with compression of the intrapancreatic portion of the common bile duct or passage of a biliary stone or sludge
  8. Abdominal tenderness and muscle rigidity are present
  9. Bowel sounds are usually diminished or absent

INVESTIGATION

BLOOD –CBC,Serum lipase,Serum amylase, LDH,Calcium

Electolytes-Na,K,HCO3,Cl

Urea, creatinine,bilirubin

CT-Abdomen

Prevention

  • Avoid chemical pesticides, chemical fertilizer for farming
  • Avoid herbicides
  • Avoid weedicides
  • Avoid rodenticide
  • Eat organic fruits, vegetable
  • Regular excersise
  • Avoid smoking
  • Eating foods high in fiber
  • Drinking an adequate amount of fluids
  • Avoid alcohol
  • Avoid tobacco

TREATMENT

HOMEOPATHY MEDICINE

 

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