This book describes Pancreatitis, Diagnosis and Treatment and Related Diseases

Pancreatitis is an acute or chronic pancreas inflammation
Chronic disease follows attacks of acute pancreas infection
The presence of gallstone is the most common cause of pancreatitis
Small gallstone blocked the bile duct causing pancreatic necrosis

Patients present with epigastric abdominal pain aggravated by eating
There may be also abdominal distension, nausea and vomiting
There may be mild fever, shock and hypotension
There may also abdominal tenderness and distension

Diagnosis is by high blood levels of lipase and amylase
An ultrasound scan may be done to look for pseudocyst in pancreas
Complications are damage to the pancreas or kidney function
There are also shortness of breath and poor food absorption

Treatment is immediate hospital treatment and admission
Pain management, nutritional support and IV hydration
Analgesic or antispasmodic medicine usually by injection
Most pancreatitis patients have complete resolution

-An original poem by Kenneth Kee

Recently a patient of mine returned from Hong Kong and had severe abdominal discomfort.

I suspected that it may food poisoning and prescribed a course of antibiotics and something to stop the abdominal cramp.

The abdominal persisted in spite of treatment so I referred him for an abdominal X-ray, ultrasound and blood tests at the nearest hospital.

Blood tests showed high levels of lipase and amylase.

Abdominal X-ray did not show any abnormality or gallstones.

Ct scan of the abdomen however showed diffuse swelling of the pancreas, suggesting together with high levels of lipase and amylase the presence of pancreatitis.

He was immediately admitted and put on a liquid diet with infusions of saline solution and antibiotics (for suspected infection) and analgesic.

His blood glucose is found to be high due to effect of reduced insulin production of the pancreas.

He has improved with the treatment and had been advised not to take excessive alcohol and fatty food which can affect his pancreas.

Pancreatitis is an inflammation of the pancreas.

When the pancreas is inflamed, the enzymes inside it digest and injure the tissues that produce them.

Pancreatitis can be acute or chronic.

Either type can be serious and cause complications.

In severe pancreatitis, bleeding, infection and permanent tissue injury may happen.

Acute pancreatitis is inflammation of the pancreas that happens suddenly and resolves in a few days with treatment.
In most patients (80%), the inflammation is mild and recovers within a week
In some patients (20%) the inflammation becomes dangerous.
Parts of the pancreas and surrounding tissues may die from necrosis of the cells.

Chronic pancreatitis is inflammation of the pancreas that does not cure or become better.
It becomes worse over time and results in permanent injury.

Pancreatitis is normally caused by:
Alcoholism and diseases of the biliary tract
Bacterial infections (streptococcus)
Viral infection (mumps)
Trauma

Symptoms:
Acute abdominal pain starting from the epigastrium, radiating to the back
Pain normally severe after a large meal or drinking bout
Pain is worse lying supine
Mild fever and bodyaches

Diagnosis:
Abdminal tenderness in the epigastrium
Serum lipase and amylase very high
CAT scan for gallstones

Treatment:
Pain medicines
I/V Fluids
No food or fluid by mouth
Antibiotics for infections
Surgery of gallstone

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