This is an acute inflammatory condition typically presenting with abdominal pain, usually associated with raised pancreatic enzymes in blood or urine.
In Britain abt 50% cases are associated with biliary disease and 20% with alcohol and in 20% of the patients no cause can be found.
The pancreas secrete the digestive enzymes as pro enzymes which are activated in the intestinal lumen. Acute pancreatitis may result when activation occurs in the pancreatic duct system or even in the pancreatic acinar cells.
The pancreas shows oedema, necrosis of acinar and duct cells and an infiltration with inflammatory cells. With progression the entire pancreas may become an inflammatory mass with hemorrhage into and around it. The release of enzymes lead to fat necrosis both in the pancreas and in the peritoneal cavity. The pancreatic secretions eventually form pseudocysts which have no epithelial lining and are lined with granulation and scar tissue.
Clinical features include sudden and severe pain in the upper abdomen, might follow large meal andalcohol.
The pain is persistent and can radiate to back and to either shoulder. Nausea and vomiting are common and in severe cases shock supervenes.
