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Acute Pancreatitis

Acute pancreatitis is one of the conditions that can cause a severe abdominal pain , a so-called “acute abdomen”.

It is defined as an inflammatory condition of the pancreatic tissue, which after its resolution returns the tissue to normal without scarring. However, this concept is false. Pathological studies have shown that there seems to be a discrepancy between the clinical impression that the condition has resolved and the histological appearance on tissue samples.

Even minor pancreatitis attacks can leave major scarring behind (Ref.5). Particularly with alcoholic pancreatitis there is evidence that alcohol can precipitate some of the protein compounds of the pancreatic juice in the ducts, which then blocks further flow of pancreatic juice and causes damage inside the pancreatic organ.

This leads to so much damage and subsequent scarring that such an acute attack, although clinically not yet apparent, has lead to a chronic pancreatitis pattern histologically. We know a lot about the possible causes of acute pancreatitis. More than 80% of all acute pancreatitis cases are due either to alcohol abuse or due to gall stones stuck in the common bile duct. The following table gives an overview of some of the various causes.

 Causes of acute pancreatitis

Frequency  of cause: Nature of cause of acute pancreatitis:
    80% alcoholism, biliary tract disease (gall stones)
    20% drugs (furosemide, azathioprine, valproic acid); hypertriglyceridemia;hyperparathyroidism; hypercalcemia; blunt or penetrating trauma to the abdomen; estrogen in women with hyperlipidemia; statins
Acute Pancreatitis (Alcohol Is One Of The Causes)

Acute Pancreatitis (Alcohol Is One Of The Causes)

Acute pancreatitis caused by statins

For many years the statins as a possible cause of pancreatitis have been overlooked until Dr.Sonal Singh of the Wake Forest University in Winston-Salem, N.C. reported in the December 2006 issue of Drug Safety that 1 person of 300,000 persons treated with statins per year will come down with acute pancreatitis. Read more details about the study in this blog.

 

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29. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 157, page1181.

30. Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc., pages 976-983: “Chapter 107 – Acute Abdomen and Common Surgical Abdominal Problems”.

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Last modified: November 2, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.