Tag Archives: Endoscopic retrograde cholangiopancreatography

Cholangitis

Definition:
Cholangitis is an infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Bile is a liquid made by the liver that helps digest food.

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Cholangitis can be life-threatening, and is regarded as a medical emergency. Characteristic symptoms include yellow discoloration of the skin or whites of the eyes, fever, abdominal pain, and in severe cases, low blood pressure and confusion. Initial treatment is with intravenous fluids and antibiotics, but there is often an underlying problem (such as gallstones or narrowing in the bile duct) for which further tests and treatments may be necessary, usually in the form of endoscopy to relieve obstruction of the bile duct.
Symptoms:
The following symptoms may occur:

*Pain on the upper right side or upper middle part of the abdomen. It may also be felt in the back or below the right shoulder blade. The pain may come and go and feel sharp, cramp-like, or dull.

*Fever and chills

*Dark urine and clay-colored stools

*Nausea and vomiting

*Yellowing of the skin (jaundice), which may come and go
Physical examination findings typically include jaundice and right upper quadrant tenderness.Charcot’s triad is a set of three common findings in cholangitis: abdominal pain, jaundice, and fever. This was assumed in the past to be present in 50–70% of cases, although more recently the frequency has been reported as 15–20%.Reynolds’ pentad includes the findings of Charcot’s triad with the presence of septic shock and mental confusion. This combination of symptoms indicates worsening of the condition and the development of sepsis, and is seen less commonly still.

In the elderly, the presentation may be atypical; they may directly collapse due to septicemia without first showing typical features. Those with an indwelling stent in the bile duct (see below) may not develop jaundice.

Causes:
Cholangitis is most often caused by a bacterial infection. This can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.

Bile duct obstruction, which is usually present in acute cholangitis, is generally due to gallstones. 10–30% of cases, however, are due to other causes such as benign stricturing (narrowing of the bile duct without an underlying tumor), postoperative damage or an altered structure of the bile ducts such as narrowing at the site of an anastomosis (surgical connection), various tumors (cancer of the bile duct, gallbladder cancer, cancer of the ampulla of Vater, pancreatic cancer, cancer of the duodenum), anaerobic organisms such as Clostridium and Bacteroides (especially in the elderly and those who have undergone previous surgery of the biliary system). Parasites which may infect the liver and bile ducts may cause cholangitis; these include the roundworm Ascaris lumbricoides and the liver flukes Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus. In people with AIDS, a large number of opportunistic organisms has been known to cause AIDS cholangiopathy, but the risk has rapidly diminished since the introduction of effective AIDS treatment. Cholangitis may also complicate medical procedures involving the bile duct, especially ERCP. To prevent this, it is recommended that those undergoing ERCP for any indication receive prophylactic (preventative) antibiotics.

The presence of a permanent biliary stent (e.g. in pancreatic cancer) slightly increases the risk of cholangitis, but stents of this type are often needed to keep the bile duct patent under outside pressure

Diagnosis:
Routine blood tests show features of acute inflammation (raised white blood cell count and elevated C-reactive protein level), and usually abnormal liver function tests (LFTs). In most cases the LFTs will be consistent with obstruction: raised bilirubin, alkaline phosphatase and ?-glutamyl transpeptidase. In the early stages, however, pressure on the liver cells may be the main feature and the tests will resemble those in hepatitis, with elevations in alanine transaminase and aspartate transaminase.

Blood cultures are often performed in people with fever and evidence of acute infection. These yield the bacteria causing the infection in 36% of cases, usually after 24–48 hours of incubation. Bile, too, may be sent for culture during ERCP (see below). The most common bacteria linked to ascending cholangitis are gram-negative bacilli: Escherichia coli (25–50%), Klebsiella (15–20%) and Enterobacter (5–10%). Of the gram-positive cocci, Enterococcus causes 10–20%.

You may have the following tests to look for blockages:

*Abdominal ultrasound

*Endoscopic retrograde cholangiopancreatography (ERCP)

*Magnetic resonance cholangiopancreatography (MRCP)

*Percutaneous transhepatic cholangiogram (PTCA)

*You may also have the following blood tests:

#Bilirubin level
#Liver enzyme levels
#Liver function tests
#White blood count (WBC)
Treatment:
Quick diagnosis and treatment are very important.Antibiotics to cure infection is the first treatment done in most cases. ERCP or other surgical procedure is done when the patient is stable.Patients who are very ill or are quickly getting worse may need surgery right away.

Cholangitis requires admission to hospital. Intravenous fluids are administered, especially if the blood pressure is low, and antibiotics are commenced. Empirical treatment with broad-spectrum antibiotics is usually necessary until it is known for certain which pathogen is causing the infection, and to which antibiotics it is sensitive. Combinations of penicillins and aminoglycosides are widely used, although ciprofloxacin has been shown to be effective in most cases, and may be preferred to aminoglycosides because of fewer side effects. Metronidazole is often added to specifically treat the anaerobic pathogens, especially in those who are very ill or at risk of anaerobic infections. Antibiotics are continued for 7–10 days. Drugs that increase the blood pressure (vasopressors) may also be required to counter the low blood pressure.
Prognosis:
Acute cholangitis carries a significant risk of death, the leading cause being irreversible shock with multiple organ failure (a possible complication of severe infections). Improvements in diagnosis and treatment have led to a reduction in mortality: before 1980, the mortality rate was greater than 50%, but after 1980 it was 10–30%. Patients with signs of multiple organ failure are likely to die unless they undergo early biliary drainage and treatment with systemic antibiotics. Other causes of death following severe cholangitis include heart failure and pneumonia.

Risk Factors:
Risk factors include a previous history of gallstones, sclerosing cholangitis, HIV, narrowing of the common bile duct, and, rarely, travel to countries where you might catch a worm or parasite infection.

Risk factors indicating an increased risk of death include older age, female gender, a history of liver cirrhosis, biliary narrowing due to cancer, acute renal failure and the presence of liver abscesses. Complications following severe cholangitis include renal failure, respiratory failure (inability of the respiratory system to oxygenate blood and/or eliminate carbon dioxide), cardiac arrhythmia, wound infection, pneumonia, gastrointestinal bleeding and myocardial ischemia (lack of blood flow to the heart, leading to heart attacks).

Prevention:
Treatment of gallstones, tumors, and infestations of parasites may reduce the risk for some people. A metal or plastic stent that is placed in the bile system may be needed to prevent the infection from returning.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000290.htm
http://en.wikipedia.org/wiki/Ascending_cholangitis

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Definition:
Endoscopic retrograde cholangiopancreatography  (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin.
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This procedure uses x-rays and an endoscope to see inside your digestive system and diagnose problems such as tumors, gallstones, and inflammation in your liver, gallbladder, bile ducts, or pancreas. Your doctor might use the test to investigate the cause of jaundice, upper abdominal pain, or unexplained weight loss.

Why an ERCP is Performed
ERCP is most commonly performed to diagnose conditions of the pancreas or bile ducts, and is also used to treat those conditions. It is used to evaluate symptoms suggestive of disease in these organs, or to further clarify abnormal results from blood tests or imaging tests such as ultrasound or CT scan. The most common reasons to do ERCP include abdominal pain, weight loss, jaundice, or an ultrasound or CT scan that shows stones or a mass in these organs.

ERCP may be used before or after gallbladder surgery to assist in the performance of that operation. Bile duct stones can be diagnosed and removed with an ERCP. Tumors, both cancerous and noncancerous, can be diagnosed and then treated with indwelling plastic tubes that are used to bypass a blockage of the bile duct. Complications from gallbladder surgery can also sometimes be diagnosed and treated with ERCP.

In patients with suspected or known pancreatic disease, ERCP will help determine the need for surgery or the best type of surgical procedure to be performed. Occasionally, pancreatic stones can be removed by ERCP.

If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing.

Preparation
For a week before the test, don’t take aspirin or other NSAIDs because they can irritate the stomach lining and increase your chance of bleeding during the procedure. Also tell the doctor if you are taking blood-thinning medicines or any diabetes medications. People with heart valve problems may also have to take antibiotics before the procedure. Avoid eating or drinking anything for eight hours before the test because it needs to be done on an empty stomach.

Tell your doctor if you are allergic to iodine, which is used for the procedure. Arrange for someone to drive you home because the medication given during the test will make you drowsy.

Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Also, the physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You must also arrange for someone to take you home—you will not be allowed to drive because of the sedatives. The physician may give you other special instructions.

What can be expected during ERCP
Your throat will be sprayed with a local anesthetic before the test begins to numb your throat and prevent gagging. You will be given medication intravenously to help you relax during the examination. While you are lying in a comfortable position on an X-ray table, an endoscope will be gently passed through your mouth, down your esophagus, and into your stomach and duodenum. The procedure usually lasts about an hour. The endoscope does not interfere with your breathing. Most patients fall asleep during the procedure or find it only slightly uncomfortable. You may feel temporarily bloated during and after the procedure due to the air used to inflate the duodenum. As X-ray contrast material is injected into the pancreatic or bile ducts, you may feel some minor discomfort.

What happens when the test is performed
The test is performed by a specially trained gastroenterologist either in the doctor’s office or in a hospital. You are usually given a sedative through an IV line. You wear a hospital gown for the procedure and lie on your side against a backrest on an x-ray table. If you wear dentures, remove them. A local anesthetic is sprayed into your throat to prevent you from having a gag reflex (choking feeling) when the endoscope is placed inside. The endoscope is about a third of an inch in diameter and 21/2 feet long with a light on the end. It also has holes at the end that allow your doctor to pump air into your intestine, squirt fluid, and suck out liquid or air.

You are asked to swallow at the moment the tube is placed into your throat. This helps guide the endoscope into your esophagus.You are likely to feel pressure against your throat while the tube is in place and you might experience a “full” feeling in your stomach. The doctor or doctor’s assistant gently advances the tube until it reaches your duodenum, the first part of the small intestine.

Next, the doctor inserts a slender tube, called a cannula, through the endoscope, and places the tip of the cannula into the bile duct or the pancreatic duct. These ducts are natural tubes of tissue that drain liquids out of the liver and pancreas. Once the tip of the cannula is lodged inside one of these ducts, the doctor injects contrast dye (usually iodine) through the cannula. The dye can be seen by x-rays, so it lights up the ducts clearly on an x-ray image, showing any obstruction (such as from gallstones or cancer) or unusual widening of the ducts (indicating an obstruction in the past). It also can light up the gallbladder, which connects to the bile duct, and helps the doctor to visualize the liver and pancreatic tissue around the ducts.

Depending on what the x-rays show, the doctor may undertake different interventions using tools operated through the endoscope. The doctor can remove gallstones or take biopsies of suspicious tissue. He or she can prop open narrowed bile ducts with a stent, a tube-shaped object that can be inserted through the scope. Depending on what is done, the test can take from 30 minutes to two hours.

Risk Factors:Complications are rare. One possibility is aspiration-accidentally inhaling saliva into the lungs – which can cause pneumonia. Other risks include inflammation of the pancreas, infection, and bleeding. Injury to the lining of the stomach, esophagus, or intestine, as well as abdominal pain and fever, can also occur.

Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum. Except for pancreatitis, such problems are uncommon.
You may have tenderness or a lump where the sedative was injected, but that should go away in a few days.

Time required to do the test:
ERCP takes 30 minutes to 2 hours. You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight.

What happens after the Test is over
You will be monitored in the endoscopy area for 1-2 hours until the effects of the sedatives have worn off. Your throat may be a little sore for a day or two. You will be able to resume your diet and take your routine medication after you leave the endoscopy area, unless otherwise instructed.

Your surgeon will usually inform you of your test results on the day of the procedure. Biopsy results take several days to return, and you should make arrangements with your surgeon to get these results. The effects of sedation may make you forget what you were instructed after the procedure. Call your surgeon’s office for the results.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/endoscopic-retrograde-cholangiopancreatography.shtml
http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/
http://www.alabangmedicalcenter.ph/patientscorner/ERCP.htm

Percutaneous Transhepatic Cholangiography (PTCA)

 

Definition:

Percutaneous transhepatic cholangiography (PTHC or PTC) is a radiologic technique used to visualize the anatomy of the biliary tract. A contrast medium is injected into a bile duct in the liver, after which X-rays are taken. It allows access to the biliary tree in cases where endoscopic retrograde cholangiopancreatography (ERCP) has been unsuccessful. Initially reported in 1937, the procedure became popular after a 1952 report in the English-language literature.

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It is an x-ray test that can help show whether there is a blockage in the liver or the bile ducts that drain it. Since the liver and its drainage system do not normally show up on x-rays, the doctor doing the x-ray needs to inject a special dye directly into the drainage system of the liver. This dye, which is visible on x-rays, should then spread out to fill the whole drainage system. If it does not, that means there is a blockage. This type of blockage might result from a gallstone or a cancer in the liver.

It is predominatly now performed as a therapeutic technique. There are less invasive means of imaging the biliary tree including transabdominal ultrasound, MRCP, computed tomography and endoscopic ultrasound. If the biliary system is obstructed, PTC may be used to drain bile until a more permanent solution for the obstruction is performed (e.g. surgery). Additionally, self expanding metal stents can be placed across malignant biliary strictures to allow palliative drainage. Percutaneous placement of metal stents can be utilised when therapeutic ERCP has been unsuccessful, anatomy is altered precluding endoscopic access to the duodenum, or where there has been separation of the segmental biliary drainage of the liver, allowing more selective placement of metal stents. It is generally accepted that percutanous biliary procedures have higher complication rates than therapeutic ERCP. Complications encountered include infection, bleeding and bile leaks.
Why the test is performed?
Bile is a by-product of protein metabolism. It is created in the liver and excreted into the intestines via the bile ducts. If bile cannot be removed from the body, it collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice).

Also, the pancreas creates digestive fluids which drain via a common bile duct into the intestine, and thus obstruction can prevent the drainage of the fluids and may cause pancreatitis (inflammation of the pancreas).

A PTCA test can help identify whether a blockage is causing the jaundice and pancreatitis.

How do you prepare for the test?
Tell your doctor if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist’s office. Also tell your doctor if you could be pregnant. If you have diabetes and take insulin, discuss this with your doctor before the test.

Most people need to have a blood test done some time before the procedure, to make sure they are not at high risk for bleeding complications. If you take aspirin, nonsteroidal anti-inflammatory drugs, or other medicines that affect blood clotting, talk with your doctor. It may be necessary to stop or adjust the dose of these medicines before your test.

You will be told not to eat anything on the morning of the test so that your stomach is empty. This is a safety measure in the unlikely case you have a complication, such as bleeding, that might require repair surgery.

What happens when the test is performed?
You lie on a table wearing a hospital gown. An IV (intravenous) line is inserted into a vein in case you need medicines or fluid during the procedure. An area over your right ribcage is cleaned with an antibacterial soap. Then the radiologist may take a picture of your abdomen with an overhead camera. Medicine is injected through a small needle to numb the skin and the tissue underneath the skin in the area where the dye is to be injected. You may feel some brief stinging from the numbing medicine.

A separate needle is then inserted between two of your ribs on your right side. A small amount of xray dye is injected, and some pictures are taken that are visible on a video screen. Your doctor adjusts the placement of the needle until it is clear that the dye is flowing easily through the ducts (drainage tubes) inside your liver.

Because taking the x-ray pictures sometimes requires a significant amount of time, the doctor replaces the needle with a softer plastic tube. First, the syringe holding the dye is detached from the top of the needle, leaving the needle in place. The doctor then gently pushes a thin wire through the needle and into the duct where the needle has been sitting. Next the needle is pulled out, sliding over the outside end of the wire. The wire is left with one end inside the liver to hold the position where the needle had been. A thin plastic tube similar to an IV line is slid along the wire, like a long bead on a string, until it is in the same place where the needle was. The wire is then pulled out, and the dye syringe is attached to the tube.

More dye is injected through the plastic tube, and pictures are taken with the video camera as the dye spreads inside the liver. If there is no blockage, the dye drains out of the liver through the bile ducts and begins to show up on the x-ray in the area of your small intestine. Once all of the needed pictures have been taken, the plastic tube is pulled out, and a small bandage is placed over your side. The whole test usually takes less than an hour.

Risk Factors:
It is possible to have serious bleeding from this test. In some cases, blood leaks to the outside surface of the liver and causes a buildup of blood there. In other cases, blood can leak directly into the liver’s drainage system, in which case it might start showing up in your intestine, causing a bloody bowel movement. It is less likely that you could develop an infection after the test. The only soreness you are likely to have is at the skin surface where the needle went in. This should last for only a day or two.

In rare cases, the dye used in the test can damage your kidneys. This kidney effect is almost always temporary, but some people have permanent damage.

As with all x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from the video x-ray in this test is very small-too small to be likely to cause any harm. (The people performing the test on you will wear lead shields, since they would otherwise be exposed to this radiation over and over, which could be more of a danger.)

Must you do anything special after the test is over?
Call your doctor right away if you have pain in your right abdomen or shoulder, fever, dizziness, or a change in your stool color to black or red.

How long is it before the result of the test is known?
You may be told a few early results of your test as soon as the test is done. It takes a day or two for the radiologist to review the x-rays more thoroughly and to give your doctor a full report.

RESULTS:-

Normal Result:-The bile ducts are normal in size and appearance for the age of the patient.

Abnormal Results:-The results may show that the ducts are enlarged, which may indicate the ducts are blocked. The blockage may be caused by infection, scarring, or stones. It may also indicate cancer in the bile ducts, liver, pancreas, or region of the gallbladder.

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*Blocked bile ducts
*Cholangitis (infection in common bile duct)
Special considerations:-
A PTCA may be done if an endoscopic retrograde cholangiopancreatography ( ERCP) cannot be performed or has failed in the past.

An MRCP (magnetic resonance cholangiopancreatography) is a newer, non-invasive imaging method, based on MRI, which provides similar views of the bile ducts.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/percutaneous-transhepatic-cholangiography.shtml
http://en.wikipedia.org/wiki/Percutaneous_transhepatic_cholangiography
http://www.healthline.com/adamcontent/percutaneous-transhepatic-cholangiogram

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ERCP (Endoscopic Retrograde Cholangiopancreatography)

Fluoroscopic image of :en:common bile duct sto...

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Endoscopic retrograde cholangiopancreatography (en-doh-SKAH-pik REH-troh-grayd koh-LAN-jee-oh-PANG-kree-uh-TAH-gruh-fee) (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin.
.click to see
ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays.

For the procedure, you will lie on your left side on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x rays. X rays are taken as soon as the dye is injected.

If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing.

Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum. Except for pancreatitis, such problems are uncommon. You may have tenderness or a lump where the sedative was injected, but that should go away in a few days.

ERCP takes 30 minutes to 2 hours. You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight.

Preparation:-
Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Also, the physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You must also arrange for someone to take you home—you will not be allowed to drive because of the sedatives. The physician may give you other special instructions.

For More Information:-
American Gastroenterological Association (AGA)
National Office
4930 Del Ray Avenue
Bethesda, MD 20814
Phone: 301–654–2055
Fax: 301–654–5920
Email: info@gastro.org
Internet: www.gastro.org

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov

Sources:http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/index.htm

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Pancreatities

Definition:
Pancreatitis is an inflammation of the Pancreas. The pancreas is a large gland behind the stomach . It secretes insulin, which is of fundamental importance in the handling of glucose. If the pancreas is not functioning properly diabetes may develop.

Another function of the pancreas is to secrete digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food.

CLICK TO SEE PICTURES......(01)..... (1).…….(2).…..(3)

In pancreatitis, the enzymes that help digest fats, proteins and carbohydrates in food become active inside the pancreas and start digesting the pancreas

Symptoms:
The symptoms of acute pancreatitis usually begins with severe pain in the upper abdomen. The pain may last for a few days. Some of the other symptoms are: swollen and tender abdomen, sweating, nausea, vomiting,fever, mild jaundice, and rapid pulse.

Diagnosis:

To diagnose pancreatitis, your doctor will take your medical history and perform a complete medical examination. He or she will be particularly interested in how much alcohol you drink and if you have had symptoms of gallstones. Diagnostic tests include blood and urine studies for pancreatic enzymes and sugars, x-rays of the abdomen and chest, ultrasound exam of the pancreas and gallbladder, and computed tomography (CT) scan of the pancreas. In severe cases of chronic pancreatitis, your doctor may order an endoscopic retrograde cholangiopancreatography (ERCP). An ERCP is a way of looking at your pancreas through a slim flexible tube, called an endoscope, that is inserted into your mouth and down to the pancreas. An endoscope is fitted with a tiny fiber optic camera that gives the physician a detailed view of the pancreas. During the ERCP, the physician can remove a sample of tissue, a biopsy, from the pancreas.In some cases the doctor may want to do Endoscoip Ultrasonography(EUS) to detect the cause of Pancreatities. Your doctor may also want a stool sample to test for excess fats.

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Types Of Pancreatities:

There are two main typs of pancreatitis: acute and chronic. Acute pancreatitis occurs suddenly and lasts for a short period of time. It ususally resolves. Some people with acute pancreatitis may have more than one attack and recover completely after each. However, acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year. About 20 percent of the cases are severe.Many young people dies in Pancreatities due to the faulty ways of drinking too much alcohol in empty stomac to get a quick kick.Several times they forget the art of drinking alcohol .Alcohol should always be drunk after eating some food or along with food,slowly (not too fast) and enjoy a soothing sensation.

Chronic pancreatitis occurs over a long period of time and does not resolve itself. Chronic pancreatitis results in a slow destruction of the pancreas. The usual cause of chronic pancreatitis is many years of alcohol abuse, but the chronic form may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged. The result of chronic pancreatitis is an inability to properly digest fat caused by a lack of pancreatic enzymes. The production of insulin is also affected.

Causes Of Pancreatities:

Acute pancreatitis is usually caused by drinking too much alcohol(sometimes specially in empty stomac) or by gallstone. A gallstone can block the pancreatic duct, trapping digestive enzymes in the pancreas and causing pancreatitis.

Chronic pancrestitis occurs when digestive enzymes attack and destroy the pancreas and nearby tissues.. Chronic pancratitis is usually caused by many years of alcohol abuse, excess iron in the blood, and other unknown factors. However, it may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged.

Complecations of Pancreatities:
Some of the complications from pancreatitis are: low blood pressure heart and kidney failure, ARDS(adult respiratory distress symdrome),diabetes, ascites,accumulation of fluid in the abdomen, ans cysts or abscesses in the pancreas.

Treatments of Pancreatities:

Treatment depends on how bad the attack is. If no complications in the form of kidney failure or lung problems occur, acute pancreatitis usually improves on its own.
The goal of therapy is to maintain circulation and fluid volume. Treatment measures must also relieve pain and decrease pancreatic secretions. In 90% of patients with acute pancreatitis, the disease occurs as a mild self-limiting illness and requires simple supportive care alone. In the remaining 10% of patients, the disease can evolve into a severe form of acute pancreatitis with significant complications, a lengthy duration of illness, and a significant mortality rate.

Prevention:

Although pancreatitis isn’t always preventable, you can take steps to reduce your risk:

  • Avoid excessive alcohol use. Overuse of alcohol (in empty stomac specially) is the leading cause of chronic pancreatitis and a contributing factor in many acute attacks.
  • Stop smoking. Tobacco use increases your risk of pancreatitis, especially if you also drink alcohol.
  • Limit fat. Eating a high-fat diet can raise your blood-fat levels and increase your risk of gallstones – both risk factors for pancreatitis. A healthy diet emphasizes fresh fruits and vegetables, whole grains, and lean protein, and limits fats, especially saturated fats such as butter.

Extracted partly from:http://www.mamashealth.com/pancreatitis.asp and http://www.diseases-conditions.info/diseases/pancreatitis.html
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.