Acute Pancreatitis (Part One)

Acute pancreatitis refers to the immediate inflammation of the pancreatic parenchyma and adjacent structures, during which activated pancreatic enzymes cause autodigestion of the pancreas itself.

Causes

1. Biliary pathologies
   • Gallstones
   • Infections (cholecystitis or cholangitis)
2. Chronic alcoholism
3. Surgical interventions (stomach, biliary tract, pancreas)
4. Trauma
5. Hyperlipidemia
6. Medications (steroids, estrogens)
7. Penetrating ulcers.
8. Acute pancreatitis is also associated with the human acquired immunodeficiency syndrome (AIDS).
9. 20% of cases with acute pancreatitis do not have an evident cause and in this case, they are classified as idiopathic.

Mostly affects males over the age of 40, especially those who are obese.

Clinical Presentation

Abdominal pain in the form of a belt, fever, nausea, vomiting, accompanied by an increase in serum amylase and lipase.

In advanced cases of acute pancreatitis, “Grey Turner’s sign” appears with bruising and discoloration of the left flank of the abdomen as well as "Cullen's sign" with bruising around the umbilicus.

Ultrasound Examination Data.

• The pancreas is enlarged and hypoechoic compared to the liver. In the early stages, it may have normal echogenicity.
• The pancreas has irregular and unclear contours.
• As a result of the increased size of the pancreas, it compresses and displaces the splenic vein downwards.
• The pancreatic duct widens over 2.5 mm
• Presence of fluid in the Lesser Sac and left phrenic-costal sinus.
• Enlargement of the head of the pancreas may compress the bile duct and cause obstruction of various degrees.