pancreatitis

Pancreatitis refers to inflammation of the pancreas, an organ involved in digestion and regulation of blood sugar. It occurs in acute episodes or as a long-term, ongoing disease, and can lead to autodigestion of pancreatic tissue and surrounding structures.

Acute pancreatitis presents with sudden, persistent upper abdominal pain that may radiate to the back, often accompanied by nausea and vomiting. The most common causes are gallstones and excessive alcohol use; other causes include hypertriglyceridemia, certain medications, traumatic injury, infections, and autoimmune conditions. Most cases are mild, but some progress to organ failure or necrosis.

Diagnosis relies on clinical features plus laboratory testing and imaging. Blood levels of pancreatic enzymes, especially lipase, are typically elevated; amylase may be elevated but is less specific. Imaging such as abdominal ultrasound or contrast-enhanced CT helps identify gallstones, complications, and the extent of inflammation.

Initial treatment focuses on supportive care: fluid resuscitation, pain control, and withholding oral intake. Identification and management of the underlying cause are important (for example, gallstone removal via ERCP, or cessation of alcohol). Infected necrosis or organ dysfunction may require antibiotics, drainage, or surgery.

Chronic pancreatitis is characterized by long-standing inflammation with progressive fibrosis, causing intermittent or constant abdominal pain and eventually exocrine and endocrine failure. Risk factors include long-term alcohol use, hereditary conditions, autoimmune pancreatitis, and genetic mutations. Management emphasizes pain control, pancreatic enzyme replacement therapy to treat malabsorption, diabetes management, nutritional support, and avoidance of alcohol and smoking. Complications can include pancreatic insufficiency, calcifications, pseudocysts, and diabetes. Prognosis depends on etiology, severity, and response to treatment.