Pancreatic Disorder

The evaluation of pancreatic diseases can be difficult due to the inaccessibility of the pancreas. There are multiple methods to evaluate the pancreas. Initial tests of the pancreas include a physical examination, which is difficult since the pancreas is deep in the abdomen near the spine. Blood tests are often helpful in determining whether the pancreas is involved in a specific symptom but may be misleading. The best radiographic tests to evaluate the structure of the pancreas include CAT (computed tomography) scan, endoscopic ultrasound, and MRI (magnetic resonance imaging). Tests to evaluate the pancreatic ducts include ERCP (endoscopic retrograde cholangiopancreatography) and MRCP(magnetic resonance cholangiopancreatography). There are also instances in which surgical exploration is the only way to confirm the diagnosis of pancreatic disease.

Acute pancreatitis is a sudden attack causing inflammation of the pancreas and is usually associated with severe upper abdominal pain. The pain may be severe and last several days. Other symptoms of acute pancreatitis include nausea, vomiting, diarrhea, bloating, and fever. In the United States, the most common cause of acute pancreatitis is gallstones. Other causes include chronic alcohol consumption, hereditary conditions, trauma, medications, infections, electrolyte abnormalities, high lipid levels, hormonal abnormalities, or other unknown causes. The treatment is usually supportive with medications showing no benefit. Most patients with acute pancreatitis recover completely.

Chronic pancreatitis is the progressive disorder associated with the destruction of the pancreas. The disease is more common in men and usually develops in persons between 30 and 40 years of age. Initially, chronic pancreatitis may be confused with acute pancreatitis because the symptoms are similar. The most common symptoms are upper abdominal pain and diarrhea. As the disease becomes more chronic, patients can develop malnutrition and weight loss. If the pancreas becomes destroyed in the latter stages of the disease, patients may develop diabetes mellitus.

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Pancreatic Disorder and Therapy