Acute pancreatitis is a discrete episode of inflammation resulting from intrapancreatic activation of digestive enzymes. It is a disease with a wide spectrum of severity, complications, and outcome.
Abdominal pain is the most common complaint in acute pancreatitis. It is usually located in the epigastrium, left upper quadrant, or periumbilical area, and often radiates to the back, chest, flanks, and lower abdomen. The pain is steady, dull, and boring in character.
Acute pancreatitis is an inflammatory disorder of the pancreas characterized by severe pain in the upper abdomen and increased serum concentrations of pancreatic lipase and amylase.
Even though there is no definite correlation between the severity of pancreatitis and the degree of serum amylase elevation, serum amylase elevation is commonly equated to the presence of pancreatitis. However, hyperamylasemia may be present in many other conditions.
Alcoholism and biliary tract disease. The two most common etiologic factors associated with pancreatitis are alcoholism and biliary tract disease (gallstones). These two factors account for 75% to 85% of all cases.
The insidious nature of chronic pancreatitis delays the early diagnosis of this disorder in many patients. Patients usually come to medical attention after considerable damage has occurred to the gland. In most cases, it is difficult to differentiate acute relapsing pancreatitis, in which the permanent pancreatic damage is mild to moderate, from chronic relapsing pancreatitis.
Chronic pancreatitis results from progressive destruction and fibrosis of the pancreas with ongoing inflammatory lesions. The exocrine pancreatic tissue and function are lost in the earlier stages, followed by the loss of endocrine parenchyma and function.