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Pancreatitis

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Pancreatitis is when the pancreas undergoes inflammation due to tissue damage and can be categorized as acute or chronic. Pancreatitis is a serious disease with the potential to lead to severe complications, organ failure, and even death. Swift diagnosis and treatment are essential.

Symptoms

In cases of pancreatitis, chronic patients account for approximately 80%, while acute circumstances, constituting 20%, exhibit severe symptoms that can be life-threatening without proper treatment.

Acute Pancreatitis	Most cases result from the destruction of the exocrine cells of the pancreas or necrosis due to obstruction of the pancreatic duct by digestive fluid. About 85%-90% of acute pancreatitis patients recover spontaneously, but 10-20% of severe cases can develop multiple organ failure, with an overall mortality rate of approximately 5%.
Chronic Pancreatitis	Chronic pancreatitis occurs when the pancreas undergoes progressive changes following repeated episodes of acute pancreatitis. The inflammatory process leads to scarring and calcification of pancreatic tissue.

Symptoms of Acute Pancreatitis include:

Pain: Approximately 95% of pancreatitis patients experience upper abdominal pain, with nearly half experiencing accompanying back pain. Eating typically exacerbates the pain, and leaning forward may provide slight relief.
Fever: Most cases exhibit moderate fever, with only a few experiencing high fever. In issues associated with biliary tract inflammation, patients may also present with jaundice and upper abdominal pain.
Grey-Turner Sign and Cullen Sign: These signs involve the appearance of subcutaneous blue-purple discolouration due to blood seeping into the retroperitoneal space behind the kidneys and then passing through the fascia of the abdominal muscles to the skin. Grey-Turner Sign occurs on both sides of the flanks, while Cullen Sign appears near the umbilicus.
Other Symptoms: Other common symptoms include nausea and vomiting, diarrhoea, fatty stools, abdominal bloating, and, in some cases, ascites or pleural effusion.

Factors

Possible causes and risks of pancreatitis:

Gallstones	Gallstones can lead to blockage of the pancreatic duct, triggering a self-digestive reaction in the pancreas, resulting in acute pancreatitis.
Alcohol Consumption	Long-term and excessive alcohol intake may lead to abnormalities in fatty acid metabolism, abnormal gallbladder contraction, immune response abnormalities, abnormal activation of proteases, affecting the normal functioning of the pancreas, and increasing the risk of acute pancreatitis.
High-Fat Diet	Excessive intake of high-fat foods may increase the risk of developing chronic pancreatitis.
Infection	Pancreatic infection is also a possible cause of acute pancreatitis.

Diagnosis

Diagnosing pancreatitis typically involves the following methods:

Clinical Diagnosis:
Doctors inquire about the patient's symptoms, including the nature of pain, frequency, duration, and other relevant symptoms. Understanding the patient's medical history and possible risk factors is equally important.

Blood Tests (Pancreatic Function Tests):
Blood tests detect pancreatic enzymes such as amylase, lipase, trypsin, elastase, etc., typically elevated during a pancreatitis episode.

Imaging Studies:

Ultrasound Examination: Ultrasound provides images of the pancreas, helping detect swelling or stones.
CT Scan: High-resolution computed tomography (CT) scans offer detailed views of the pancreas structure, aiding in identifying inflammation and other changes.
MRI: Magnetic resonance imaging provides more explicit images of the pancreas, assisting in confirming the diagnosis.

Endoscopic Examinations:

Endoscopic Retrograde Cholangiopancreatography (ERCP): This involves introducing a catheter through an endoscope to examine the condition of the bile ducts and pancreas.
Endoscopic Ultrasound (EUS): Endoscopic ultrasound provides more precise images of the pancreas.

Tissue Biopsy (Biopsy):
In some cases, a biopsy of pancreatic tissue may be necessary to confirm the diagnosis and rule out other potential causes.