Pancreatitis

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Pancreatitis

By | Jan. 2011
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Trauma – Abdominal trauma causes an elevation of amylase and lipase levels in 17% of cases and clinical pancreatitis in 5% of cases. Blunt abdominal trauma is considered to be the cause of one fifth of all cases of traumatic pancreatitis and it may result in contusion, parenchymal (Islets of Langerhans and pancreatic acini) fracture, or ductal disruption. Blunt injury may crush the gland across the spine, leading to a ductal injury in that location.

Alcohol – Damage from alcohol abuse may not appear for many years, and then a person may have a sudden attack of pancreatitis. In up to 70 percent of adult patients, chronic pancreatitis appears to be caused by alcoholism.

Biliary Tract Disease – Occasionally the gallstones can also block the flow of digestive enzymes from the pancreas since both the bile ducts and pancreas ducts drain through the same small opening (called the Ampulla of Vater) which is held tight by a small circular muscle (called the Sphincter of Oddi). This results in inflammation of the pancreas. This is known as gallstone pancreatitis.

Viral or Bacterial Disease – Viral causes include mumps, Epstein-Barr, coxsackievirus, echovirus, varicella-zoster, and measles. Bacterial causes include Mycoplasma pneumoniae, Salmonella, Campylobacter, and Mycobacterium tuberculosis.

Hyperlipidemia – It is thought to involved increased chylomicrons in the blood. Chylomicrons are very large triglyceride carrying molecules that are present in the highest concentrations 1-3 hours after eating. Typically, they are cleared from the blood within 8 hours. However, when triglyceride levels are very high (exceeding 1,000 mg/dL), chylomicrons are almost always present in the blood. Since they are very large, they may obstruct small vessels leading to ischemia and acidemia. This local damage can cause pancreatic lipases to degrade triglycerides within chylomicrons. The degradation of triglycerides to free fatty acids and glycerol in the pancreas leads to...