Acute pancreatitis

Pancreas
3D Medical Animation still shot of Acute Pancreatitis
Axial CT in a patient with acute exudative pancreatitis showing extensive fluid collections surrounding the pancreas.
Abdominal ultrasonography of acute pancreatitis.

Sudden inflammation of the pancreas.

- Acute pancreatitis

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Pancreatic duct

Duct joining the pancreas to the common bile duct.

The pancreatic duct
Formation of an accessory pancreatic duct
ERCP image showing the pancreatic duct and biliary tree.
Accessory digestive system.
Interior of the descending portion of the duodenum, showing bile papilla.
Pancreas of a human embryo of five weeks.
Pancreas of a human embryo at end of sixth week.
Pancreatic duct Deep dissection.Anterior view.
Ultrasonography of a dilated pancreatic duct (in this case 9mm) due to pancreatic cancer.

Compression, obstruction or inflammation of the pancreatic duct may lead to acute pancreatitis.

Gallstone

Stone formed within the gallbladder out of precipitated bile components.

Gallstones typically form in the gallbladder and may result in symptoms if they block the biliary system.
From left to right: cholesterol stone, mixed stone, pigment stone.
Gallbladder opened to show small cholesterol gallstones
X-ray microtomograph of a gallstone
The large, yellow stone is largely cholesterol, while the green-to-brown stones are mostly composed of bile pigments
Large gallstone
Numerous small gallstones made up largely of cholesterol
A 1.9 cm gallstone impacted in the neck of the gallbladder and leading to cholecystitis as seen on ultrasound. There is 4 mm gall bladder wall thickening.
Biliary sludge and gallstones. There is borderline thickening of the gallbladder wall.
Gallstones as seen on plain X-ray
Large gallstone as seen on CT

Other complications include ascending cholangitis if there is a bacterial infection which can cause purulent inflammation in the biliary tree and liver, and acute pancreatitis as blockage of the bile ducts can prevent active enzymes being secreted into the bowel, instead damaging the pancreas.

Chronic pancreatitis

Long-standing inflammation of the pancreas that alters the organ's normal structure and functions.

Axial CT showing multiple calcifications in the pancreas in a patient with chronic pancreatitis
PRSS1

It is a disease process characterized by irreversible damage to the pancreas as distinct from reversible changes in acute pancreatitis.

Hypovolemia

State of abnormally low extracellular fluid in the body.

A diagram showing the formation of interstitial fluid from the bloodstream.
Pathophysiology of hypovolemia

Acute pancreatitis

Hypertriglyceridemia

Presence of high amounts of triglycerides in the blood.

Blood samples of a young patient with extreme hypertriglyceridemia
Triglyceride, which cause hypertriglyceridemia at high level

Extreme triglyceride levels also increase the risk of acute pancreatitis.

Jaundice

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Jaundice of the skin caused by pancreatic cancer
A 4-year-old boy with icteric sclera due to G6PD deficiency
Types of jaundice
Microscopy of a biopsy of a cholestatic liver showing bilirubin pigment (brown pigment), H&E stain
Biliary-tract dilation due to obstruction as seen on CT scan (frontal plane)
Biliary-tract dilation due to obstruction as seen on CT scan (axial plane)

Acute Pancreatitis

Epigastrium

Upper central region of the abdomen.

Surface lines of the front of the thorax and abdomen

Pain may also be referred from the pancreas, such as in acute pancreatitis.

Nothing by mouth

Medical instruction meaning to withhold food and fluids.

The typical reason for NPO instructions is the prevention of aspiration pneumonia, e.g. in those who will undergo general anesthesia, or those with weak swallowing musculature, or in case of gastrointestinal bleeding, gastrointestinal blockage, or acute pancreatitis.

Kidney failure

Medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels.

A hemodialysis machine which is used to replace the function of the kidneys
Illustration of a kidney from a person with chronic renal failure

However, the rate of acute pancreatitis does not differ from the general population.

Sulfonamide (medicine)

Functional group that is the basis of several groups of drugs, which are called sulphonamides, sulfa drugs or sulpha drugs.

Sulfonamide functional group
Hydrochlorothiazide is a sulfonamide and a thiazide.
Furosemide is a sulfonamide, but not a thiazide.
Sulfamethoxazole is an antibacterial sulfonamide
Structural similarity between sulfanilamide (left) and PABA (center) is the basis for the inhibitory activity of sulfa drugs on tetrahydrofolate (right) biosynthesis.

However, there are several life-threatening manifestations of hypersensitivity to sulfa drugs, including Stevens–Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, hemolytic anemia, thrombocytopenia, fulminant hepatic necrosis, and acute pancreatitis, among others.