Acute pancreatitis

Definition

Acute pancreatitis is an inflammation (irritation and swelling) of the pancreas. The pancreas is a long gland, located behind the stomach, that secretes digestive enzymes and the hormones insulin and glucagon.

Causes

The chief causes of acute pancreatitis in adults are gallstones, other gallbladder (biliary) disease, and alcohol use. Other causes include:

• Viral infection (mumps, coxsackie B, mycoplasma pneumonia, and campylobacter)
• Traumatic injury
• Pancreatic surgical procedures
• Common bile duct surgical procedures
• Certain medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine)

Acute pancreatitis may also be caused by an abnormal structure of the pancreas, genetic factors (hereditary pancreatitis), high lipid levels in the blood (hypertriglyceridemia), and complications of cystic fibrosis.

The mechanism that causes pancreatitis is not well known. It is thought that enzymes normally secreted by the pancreas in an inactive form become activated inside the pancreas and start to digest the pancreatic tissue. This process is called autodigestion and causes swelling, hemorrhage, and damage to the blood vessels.

The disease affects men more often than women. Alcohol abuse is an important risk factor.

In children, this disorder may be associated with:

• Abdominal trauma
• Cystic fibrosis
• Hemolytic uremic syndrome
• Kawasaki disease
• Mumps
• Reye syndrome
• Various viral illnesses
• Some medications

References

Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006 Oct;101(10):2379-400.