Disorders of the Gastrointestinal System, 2nd Edition
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are three times more likely to be hospital- ized for it (Tang, 2021). Causes of pancreatitis include (Tang, 2021): ● Biliary tract diseases or disorders. ● Trauma. ● Alcohol abuse. ● Certain medications. ● Other diseases or conditions, such as AIDS or vasculitis. ● Endoscopic retrograde. cholangiopancreatography (ERCP): Risk of pancreatitis after it is performed. Although many symptoms of pancre- atitis are the same, whether it is acute or chronic, there are some differences. For example, the abdominal and back pain from chronic pancreatitis often worsens after eating, and it may go away entirely as the condition progresses. With acute pancreatitis, on the other hand, the pain typically worsens until the condition is treated (Gapp et al., 2022). Symptoms of pancreatitis include (Tang, 2021): ● Diarrhea. ● Greasy stools. ● Nausea and vomiting. ● Tachycardia. ● Pain radiating from the abdomen to the back. ● Fever. ● Swelling in the abdomen. ● Jaundice. ● Hemodynamic instability if a bleed is present. Most cases of pancreatitis can be diag - nosed by identifying symptoms, obtain- ing lab values, and taking a thorough clin- ical history. Imagining may be required for cases where the diagnosis is not de- termined by these methods (Tang, 2021).
Diagnostic tests for pancreatitis include (Vege, 2022): ● Serum amylase and lipase levels will likely be elevated in those with acute pancreatitis. ● Kidney function tests are often elevated because of the electrolyte imbalances caused by pancreatitis. ● Trypsinogen activation peptide (TAP) becomes elevated and is particularly helpful for identifying early pancreatitis. ● A complete blood count will show an elevated WBC. Lower hemoglobin and hematocrit levels may indicate that the patient is bleeding. In contrast, patients with pancreatitis can lose fluid into third spaces, causing concentrated hematocrit levels due to the concentration of the vascular fluid. ● Liver enzymes, if elevated, can indicate the cause is related to gallstones (Tang, 2021). ● Abdominal imaginings such as x-rays, ultrasound, MRI, or CT scans may be indicated if laboratory testing is inconclusive. Treatment of pancreatitis includes keeping the patient on a nothing-by- mouth (NPO) diet until pain and nausea resolve; aggressive IV hydration; remov- ing the root cause if determined, such as gallstones or causative medications; and close monitoring for the development of an infection, bleeding, or worsening overall condition. In most cases, antibi- otics are unnecessary or not recommend- ed unless infected pancreatic necrosis is suspected (Tang, 2021). The patient may need to stay in an intensive care unit (ICU) for treatment or management of compli- cations.
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