Pancreatitis: Pancreas and Gastrointestinal Inflammatory Agents

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Brandon C. Hyatt
Salem State University

The first part of this paper will be an overview of the pathophysiology of pancreatitis, which is an inflammation of the pancreas, and the second part will elaborate on my clinical experience with a patient I was taking care that suffered from pancreatitis. The pancreas is the organ within the human body that is located underneath the stomach and is responsible for insulin production and other certain digestive enzymes. Inflammation in the pancreas is caused by the infiltration of pancreatic enzymes into the tissues of the pancreas, which in turn cause irritation and edema to the surrounding tissues (Lewis et al., 2007). There are two types of pancreatitis, acute and chronic, of which both exhibit similar symptoms. Vege (2010) states, “once the diagnosis of acute pancreatitis has been established, the cause of the pancreatitis should be determined. Gallstones and alcohol abuse account for 60 to 75 percent and should be diligently looked for in all patients presenting with pancreatitis.” Acute pancreatitis is a short-term condition of which the inflammatory process will generally remain localized in the pancreas. According to Vege (2010), symptoms of acute pancreatitis mainly consist of severe upper abdominal pain and increased blood levels of pancreatic digestive enzymes. The pain may be localized to the upper left and/or right quadrant of the abdomen, or the mid-epigastrium. Pain can range from mild to severe, may be steady or infrequent, and it can localize in the pancreas or radiate to other organs and parts of the body, such as the back. A patient may experience a slight fever, nausea, vomiting, swollen or distended abdomen, and increased blood pressure. Chronic pancreatitis is a long-term condition of which the symptoms can come and go throughout the remainder of the patient’s lifetime. Freedman (2009) states, “patients with chronic calcifying disease, particularly those who develop early calcifications, may develop diabetes more frequently than those with chronic noncalcifying disease…glucose intolerance occurs with some frequency in chronic pancreatitis, but overt diabetes mellitus usually occurs late in the course of disease.” Other complications of acute and chronic pancreatitis are infection, hypoxia due to lack of oxygen to bodily tissues, kidney failure, and severe tissue damage. This can also lead to hemorrhaging, fluid accumulation in the abdominal cavity, and even shock due to failure of other bodily organs. If these symptoms are left untreated or overlooked, it can result in death of that patient (Freedman 2009). Diagnostic tests are necessary in order to confirm and diagnose a patient with pancreatitis. The main reason for this is because pancreatitis omits similar signs and symptoms of other acute illnesses. These diagnostic tests may include ultrasounds, CT scans, x-rays, blood and urine tests (mainly amylase, lipase, and trypsin), fine needle aspiration, and an endoscopic procedure. (Vege, 2010). According to Vege (2010), treatment of pancreatitis depends on the severity of the diagnosis can result in surgery or just a simple modification in diet along with other prescribed medicines, such anti-inflammatory, anti-emetics, antibiotics, and pain medicine. Surgery, again, depends on the severity of the diagnosis and more importantly the cause. If gallstones are the cause then the patient’s gallbladder will be removed. A patient may also need surgery if there is severe infection or necrosis of tissue in the pancreas; in that case the infected or necrotic tissue will be removed (necrosectomy). Lastly, a patient may have surgery in order to open up and clear the pancreatic ducts in order to allow proper secretion of the pancreatic digestive enzymes into the intestines. Vege (2010) states, some nursing interventions include: controlling the pain of the patient, the avoidance and control of infection, IV therapy due to a fluid and electrolyte...
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