The main symptoms of acute pancreatitis are severe abdominal pain, which is of a piercing nature and rapid weight loss.
In about half of the cases the pain irradiates right through into the back. There is a tendency of pancreatitis due to gall stones to develop within hours or 1 to 2 days. Acute pancreatitis due to alcohol seems to develop more gradually over days, if not weeks. However, there are many exceptions to this.
Once the pain is present, it is so severe that it requires large amounts of narcotics to control it. The pain stays usually for several days. It is best handled with meperidine (Demerol) injections, as morphine contracts the sphincter of Oddi, the valve that controls the opening of the pancreatic duct and the common bile duct as it connects to the duodenum. However, Demerol relaxes that sphincter.
Obstructed bile flow
If a gall stone is caught there it would obstruct the bile flow and the pancreatic juice flow simultaneously thus producing both cholecystitis and acute pancreatitis. There may be jaundice as well. As pancreatitis is so excruciatingly painful, the patient might not be aware that there might be two conditions at the same time. The moment the gall stone passes, things usually settle down fairly quickly for the cholangitis and also in a few days for the pancreatitis. Other symptoms are vomiting, and dry heaves, rapid breathing, a fever, confusion and loss of consciousness in severe cases. About 1 in 5 patients with pancreatitis will notice an upper abdominal distension or severe bloating.
Inflammatory secretions around the pancreas
This originates from severe inflammatory secretions around the pancreas which can push the stomach forward and that can be seen as a bulge and felt as a rigidity in the upper abdomen, when the physician examines. Such cases must be observed very carefully as they are possibly the ones that will lead to complications. The surrounding tissues can be directly affected by the lytic enzymes from the pancreatic juice, which can eat its way through any tissue into the abdominal cavity or through veins into the circulatory system leading to shock and sepsis. Such patients are extremely sick and belong into the Intensive Care Unit (ICU).
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