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Pancreatitis - Medical Malpractice
Pancreatitis involves a painful inflammation of the pancreas. The pancreas is a long and thin gland residing underneath the stomach and adjacent to the liver. It contains the pancreatic duct that links in with the biliary duct system and sends out digestive juices to the duodenum so that food is digested. It also contains islet cells which are important in the metabolism of carbohydrates and sugars. The islet cells produce insulin, necessary to help the cells use insulin. Glucagon is also produced by the pancreas, which is involved in sugar metabolism.
Pancreatitis can be acute or chronic. It can last for several days if it is acute and gradually resolves itself with proper treatment. Alcoholics and those with chronic biliary disease can have chronic pancreatitis that comes on gradually and can last for many years. Some types of pancreatitis can resolve without treatment but severe pancreatitis can be lethal.
The signs and symptoms of acute pancreatitis include having upper abdominal pain, pain radiating to the back, pain relieved by curling up oneself and things like nausea and vomiting. The abdomen is tender and the patient appears acutely ill and in severe pain.
Those with chronic pancreatitis may have a gradual onset of symptoms. Pain is present in the upper abdomen but is tolerable. Patients feel like they have chronic indigestion and the pain is worsened by eating. Weight loss is common and stools are fatty in nature, a condition known as steatorrhea, or fatty, smelly stools.
The cause of pancreatitis is the overproduction of digestive enzymes that go nowhere so they begin to digest the pancreatic tissue itself. The pancreatic enzymes are activated within the pancreas and are harmful to the pancreas. The pancreatic tissue becomes inflamed and scar tissue forms within the pancreas. Eventually the pancreas fails to work very well and chronic pancreatitis ensues. The act of digestion doesn't go normally and the patient can develop diabetes if the pancreas is damaged enough.
The main underlying factors that occur with having pancreatitis are gallstones, alcoholism, certain kinds of abdominal surgeries that can damage the gland, being a smoker, taking certain medications, having cystic fibrosis, having a family history for pancreatitis and having an ERCP for the treatment of gallstones. You can also get a high blood calcium as a cause of pancreatitis, as can having high triglycerides, having pancreatic cancer or an infection or injury to the pancreas.
Pancreatitis can lead to severe complications. There can be low blood oxygen levels, difficulty breathing, severe diabetes, malnutrition from poor digestion, bloodborne infection, pancreatic cancer and the formation of pseudocysts, which are balls of debris and fluid that form in and around the pancreas. They need to be removed and drained because, if they burst, they can be dangerously toxic to the human body.
Doctors can test for the presence of pancreatitis by doing a blood level of amylase and lipase, enzymes released when the pancreas is damaged. CT scan or MRI scan can be done to show enlargement of the pancreas or the presence of pseudocysts. An endoscopic ultrasound can show the same things.
The treatment of pancreatitis involves hospitalizing the patient, having them eat and drink nothing and giving them IV fluids and pain control. The pancreas will be allowed to rest. As pancreatitis is usually extremely painful, strong pain medications are usually given.
The treatment of pancreatitis may mean stopping the underlying cause of the disease. This means stopping alcohol consumption or treating biliary disease. An ERCP with sphincterotomy opens up the duodenal sphincter within the duodenum and allows the common bile duct to drain out any gallstones or sludge that is causing the problem. Removal of the gallbladder sometimes helps and is often done at the same time as surgery to remove pseudocysts, if present. Doctors give pancreatic enzymes in order to aid digestion while the pancreas is healing.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here