Synonyms: Pancreatitis; PancreatitisThe inflammation of the pancreas can be divided clinically into two different forms, the acute and chronic form. In the case of an acute inflammation of the pancreas, the affected patients experience severe pain in the upper abdomen which sets in suddenly and without warning. In addition, the presence of an acute inflammation of the pancreas is usually indicated by nausea, vomiting, constipation and high fever.
Treatment of acute inflammation of the pancreas is carried out by intravenous administration of fluid and painkillers (analgesics). A chronic inflammation of the pancreas, on the other hand, is characterized by recurrent (recurrent) pain in the upper abdomen. Nausea and vomiting can also occur in the presence of chronic inflammation of the pancreas. However, the affected patients also notice a steady weight loss. Irrespective of which form of pancreatic inflammation the patient is suffering from, a specialist should be consulted immediately and appropriate treatment with medication should be initiated.
Acute inflammation of the pancreas
Acute inflammation of the pancreas is characterized by self-digestion of the organ. In affected patients, various digestive enzymes (e.g. trypsinogen and phospholipase A) are already activated inside the pancreas. The digestive enzyme trypsinogen is believed to play a decisive role in the development of acute pancreatic inflammation.
This enzyme is a substance that is usually only broken down into its active form (trypsin) in the duodenum. If this activation occurs too early, i.e. already within the pancreas, proteolytic and lipolytic events occur. This leads to self-digestion of the organ and the development of pronounced inflammatory processes. Acute inflammation of the pancreas is a potentially life-threatening disease that requires urgent medical intervention. On average, there are about five to ten new cases per 100,000 inhabitants per year in Germany.
Causes
The acute course of the inflammation of the pancreas can have different causes. In this context, gallstones (choledocholithiasis) are the most common cause of acute inflammation of the pancreas. After these gallstones have been flushed out of the gallbladder, they can become lodged in the opening of the bile duct into the duodenum.
Since this orifice is also the exit point of the pancreatic duct (papilla vateri), a backflow of the synthesized secretions is triggered. As a result, the pancreatic tissue is damaged by the bile acid. In addition, the regular excessive consumption of alcoholic beverages is one of the main causes for the development of acute inflammation of the pancreas.
Chronic alcohol abuse leads to an increase in permeability of the ductal system inside the pancreas and, as a result, to relevant changes in the secretion and composition of bile. In addition, various occlusion systems of the bile and pancreatic duct system are negatively influenced by regular consumption of alcoholic beverages. However, in about 15% of the patients affected by acute inflammation of the pancreas, no direct explanation for the development of the disease pattern can be found, despite extensive search for causes. In these cases, one speaks of a so-called “idiopathic acute inflammation of the pancreas”. Other causes of acute pancreatitis are:
- Viral infections (mumps, hepatitis, HIV, cytomegaly)
- Elevated blood calcium levels in parathyroid hyperfunction
- Highly elevated blood lipid values (hypertriglyceridemia)
- Tumors
- Genetic (for example in cystic fibrosis)
- Autoimmune diseases
- Traumatic
- Medication-associated
