Acute pancreatitis is sudden swelling and inflammation of the pancreas.
The pancreas is an organ located behind the stomach that produces chemicals called enzymes, which are needed to digest food. It also produces the hormones insulin and glucagon. Most of the time, the enzymes are only active after they reach the small intestine.
When these enzymes become active inside the pancreas, they digest the tissue of the pancreas. This causes swelling, bleeding (hemorrhage), and damage to the organ and its blood vessels. This condition is called acute pancreatitis.
Acute pancreatitis affects men more often than women. Certain diseases, surgeries, and habits make you more likely to develop this condition. The two most common causes of pancreatitis in the United States are heavy alcohol use and gallstones.
Alcohol use is responsible for up to 70% of cases in the United States. Acute pancreatitis typically requires 5 to 8 drinks per day for 5 or more years. Gallstones are the next most common cause. The condition develops when the gallstones travel out of the gallbladder into the bile ducts, where they block the opening that drains the common bile duct and pancreatic duct (ampulla). Genetics may be a factor in some cases. Sometimes, the cause is not known.
Other conditions that have been linked to pancreatitis are:
Other causes include:
The main symptom of pancreatitis is pain felt in the upper left side or middle of the abdomen. The abdominal pain:
People with acute pancreatitis often look ill and have a fever, nausea, vomiting, and sweating.
Other symptoms that may occur with this disease include:
The doctor will do a physical exam, which may show:
Lab tests that show the release of pancreatic enzymes will be done. These include:
Other blood tests that can help diagnose pancreatitis or its complications include:
Imaging tests that can show inflammation of the pancreas include:
Treatment often requires a stay in the hospital. It may involve:
A tube may be inserted through the nose or mouth to remove the contents of the stomach (nasogastric suctioning). This may be done if vomiting and severe pain do not improve, or if a paralyzed bowel (paralytic ileus) develops. The tube will stay in for 1 - 2 days to 1 - 2 weeks.
Treating the condition that caused the problem can prevent repeated attacks.
In some cases, therapy is needed to:
In the most severe cases, surgery is needed to remove damaged, dead or infected pancreatic tissue.
Avoid smoking, alcoholic drinks, and fatty foods after the attack has improved.
Most cases go away in a week. However, some cases develop into a life-threatening illness.
The death rate is high with:
Pancreatitis can return. The chances of it returning depend on the cause, and how well it can be treated. Complications of acute pancreatitis may include:
Repeat episodes of acute pancreatitis can lead to chronic pancreatitis.
Call your health care provider if:
You may lower your risk of new or repeat episodes of pancreatitis by taking steps to prevent the medical conditions that can lead to the disease:
Forsmark CE. Pancreatitis. In: Goldman L, Shafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 146.
Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology Guideline: Management of Acute Pancreatitis. Am J Gastroenterol. 2013; 108:1400-1415.
Tenner S, Steinbert WM. Acute pancreatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 58.
Updated by: Todd Eisner, MD, in private practice specializing in gastroenterology, Boca Raton, FL. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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