It is an inflammation of the pancreas & additional deliberation of enzymes from the exocrine portion of the pancreas.
(1) Biliary tract disease ; (2) Alcoholism ; (3) Idiopathic ; (4) Infectious diseases e.g. mumps ; (5) Drugs ; corticosteroids, thiazide diuretics, sulfasalazine, (6) Miscellaneous ; hyperlipoproteinmia, hyperparathyroidism & trauma.
The patient complains of severe abdominal pain which is epigastric or sometimes radiates to the back. Nausea, vomiting, constipation, fever, mild jaundice are additional complaints. Shock may occur in severe attack.
Per abdomen : Guarding and abdominal rigidity and rebound tenderness diminished bowel sounds and abdominal distension may occur. Acute renal failure may occur in the early stage of the disease. Leucocytosis, proteinuria, glycosuria, hyperglycaemia. There may be elevation of serum bilirubin, alkaline phosphatase, amylase, lipase. Radiography : Plain X-ray for gall stones ; gas distended in the small bowel or fluid in pleural cavity. Ultrasonography may be done.
Medical : 1. Nothing by month 2. Continuous nasogastric suction. 3. Inj pethidine 100 mg IM to control severe pain. 4. If the patient is in shock ; 250-500 c.c fresh frozen plasma IV. If shock persists plasma volume is maintained and norepenephrine are required. Calcium gluconate IV if there hypocalcaemia.
Antibiotics ; Ampicillin 500 mg 6 hourly orally. When conservative measures fails peritoneal dialysis.
Surgical measures are indicated when conservative treatment fails or diagnosis is uncertain or if there is stone in bile duct.