Acute pancreatitis (inflammation of the Pancreas) comes in mild and severe forms.
What does the Pancreas do?
The Pancreas is a leaf shaped organ extending from the midline to behind the stomach. The Pancreas is an essential organ involved in both digestion of food and the maintenance of a normal blood sugar. It secretes a number of enzymes responsible for the breakdown of food into smaller molecules. It also produces insulin and glucagons, which are key hormones regulating blood sugar.
What is pancreatitis?
Acute pancreatitis (inflammation of the Pancreas) comes in mild and severe forms. Mild pancreatitis is treated with pain relief and by resting the organ (the patient is not allowed to eat). In severe disease the effects of the inflammation spread to other organs and the patient will require intensive medical therapy. The main causes of pancreatitis are gallstones and excess alcohol consumption, however in a number of cases the cause may not be identified. Diagnosis of acute pancreatitis is usually made based on clinical examination, history and blood tests. If the diagnosis is not clear an abdominal CT scan will be done. If there is a history of gallstones, an abdominal ultrasound may also be ordered.
What happens in intensive care?
Patients with mild disease will be cared for in a general ward whereas patients with severe disease may require admission to a high dependency unit or intensive care. Treatment for acute pancreatitis will include intravenous fluids, fasting the patient and insertion of a nasogastric tube. This reduces the work that the Pancreas would normally do. Pain relief may be given using a patient controlled analgesic device (known as a PCA) or a continuous infusion of morphine or other 'opiate' pain relief. Once in intensive care, close monitoring of vital signs will be done using a bedside monitor with continuous monitoring of heart rate and oxygen saturation as well as their blood sugar (BSL) checked on a regular basis. The patient may have a central venous catheter, an arterial line and an indwelling urinary catheter inserted. Other treatment will depend upon the complications that the patient may develop. These may include breathing difficulties, which could be as severe as adult respiratory distress syndrome, severe shock and acute renal failure. Respiratory support may include non-invasive mask ventilation using a BiPAP machine or full support using an endotracheal tube (breathing tube) and ventilator (the breathing machine). You can expect the patient to have frequent chest x-rays and blood tests especially arterial blood gases (ABGs). Providing adequate nutrition can be difficult with a number of patients requiring intravenous feeding (total parenteral nutrition).
How long will the patient remain in Intensive care?
Around 20 to 30% of patients with acute pancreatitis will have severe disease and face a long complicated recovery and some may experience a number of setbacks. This can mean weeks to months in intensive care or repeated admissions to intensive care. A number of patients will require more than 1 operation to remove dead pancreatic tissue or to drain abscesses. A small number of patients will develop multiple complications including shock or kidney or respiratory failure. This group of patients will experience a long and difficult recovery and have an increased risk of death.
The information contained on this page is general in nature and therefore cannot reflect individual patient variation. In addition it reflects Australian intensive care practice which may differ from other countries. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. ICCMU attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.