Pancreatitis
The pancreas and surrounding organs
Specialty	Gastroenterology, general surgery
Symptoms	Pain in the upper abdomen, nausea, vomiting, fever, fatty stool [1]
Complications	Infection, bleeding, diabetes mellitus [1]
Duration	Short or long term [1]
Causes	Gallstones, heavy alcohol use, direct trauma, certain medications, mumps [1]
Risk factors	Smoking [2] [3]
Diagnostic method	Based on symptoms, blood amylase or lipase [4] [1]
Treatment	Intravenous fluids, pain medication, antibiotics [1]
Frequency	8.9 million (2015) [5]
Deaths	132,700 (2015) [6]

Pancreatitis is a condition characterized by inflammation of the pancreas. ^[1] The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. ^[1] There are two main types: acute pancreatitis, and chronic pancreatitis. ^[1] Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting. ^[1] The pain often goes into the back and is usually severe. ^[1] In acute pancreatitis, a fever may occur, and symptoms typically resolve in a few days. ^[1] In chronic pancreatitis weight loss, fatty stool, and diarrhea may occur. ^{[1] [4]} Complications may include infection, bleeding, diabetes mellitus, or problems with other organs. ^[1]

The two most common causes of acute pancreatitis are a gallstone blocking the common bile duct after the pancreatic duct has joined; and heavy alcohol use. ^[1] Other causes include direct trauma, certain medications, infections such as mumps, and tumors. ^[1] Chronic pancreatitis may develop as a result of acute pancreatitis. ^[1] It is most commonly due to many years of heavy alcohol use. ^[1] Other causes include high levels of blood fats, high blood calcium, some medications, and certain genetic disorders, such as cystic fibrosis, among others. ^[1] Smoking increases the risk of both acute and chronic pancreatitis. ^{[2] [3]} Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase. ^[1] In chronic pancreatitis, these tests may be normal. ^[1] Medical imaging such as ultrasound and CT scan may also be useful. ^[1]

Acute pancreatitis is usually treated with intravenous fluids, pain medication, and sometimes antibiotics. ^[1] Typically eating and drinking are disallowed, and a nasogastric tube is placed in the stomach. ^[1] A procedure known as an endoscopic retrograde cholangiopancreatography (ERCP) may be done to examine the distal common bile duct and remove a gallstone if present. ^[1] In those with gallstones the gallbladder is often also removed. ^[1] In chronic pancreatitis, in addition to the above, temporary feeding through a nasogastric tube may be used to provide adequate nutrition. ^[1] Long-term dietary changes and pancreatic enzyme replacement may be required. ^[1] And occasionally surgery is done to remove parts of the pancreas. ^[1]

Globally, in 2015 about 8.9 million cases of pancreatitis occurred. ^[5] This resulted in 132,700 deaths, up from 83,000 deaths in 1990. ^{[6] [7]} Acute pancreatitis occurs in about 30 per 100,000 people a year. ^[2] New cases of chronic pancreatitis develop in about 8 per 100,000 people a year and currently affect about 50 per 100,000 people in the United States. ^[8] It is more common in men than women. ^[1] Often chronic pancreatitis starts between the ages of 30 and 40 while it is rare in children. ^[1] Acute pancreatitis was first described on autopsy in 1882 while chronic pancreatitis was first described in 1946. ^[8]

References