Apollo Hospitals International, Ahmedabad

Pancreas is a narrow, flat organ about six inches long, with head, middle & tail section. It is located below liver, between stomach and spine with head section connecting to the duodenum. Inside pancreas, small ducts (tubes) feed fluids produced by pancreas into pancreatic duct.

The primary diseases of pancreas are pancreatitis that can be classified as:

• Acute pancreatitis/ chronic pancreatitis
• Cancer of pancreas

Pancreatitis

Pancreatitis is inflammation of pancreas. It is caused when digestive enzymes from exocrine pancreas become activated inside the pancreas, instead of in duodenum and start “digesting” pancreas itself. The symptoms include:

• Abdominal pain
• Nausea and vomiting

Acute pancreatitis

• It may be single or recurring event and usually occurs suddenly
• Abdominal pain in acute pancreatitis is often severe
• Disease may even lead to internal bleeding
• Infection can also be life-threatening

Causes:

• Blockage of pancreatic duct by gallstones

Symptoms:

• Raised levels of pancreatic enzymes in blood

These enzymes can also circulate to other body organs causing shock & organ failure. Other causes include:

• Biliary tract disease (obstruction, gallstones or sludge)
• Excess alcohol
• Physical trauma to the abdomen
• Hyperlipidemia
• Hypercalcemia

 
Chronic pancreatitis

It is characterized by chronic or persistent abdominal pain & may/ may not be present with raised pancreatic enzymes. It develops gradually, often resulting in slow destruction of pancreas that can lead to other problems like:

• Pancreatic insufficiency
• Bacterial infections
• Type 2 diabetes

The main causes of chronic pancreatitis are:

• Gall bladder disease (ductal obstruction)
• Alcoholism

Other causes of chronic pancreatitis include:

• Cystic fibrosis
• Hypercalcemia
• Hyperlipidemia
• Some drugs
• Autoimmune conditions

Pancreatic Cancer

Cancer of pancreas is fourth leading cause of cancer death. The causes are:

• Smoking
• Age
• Gender (more common in men)
• Chronic pancreatitis
• Exposure to some industrial chemicals

Most (95%) pancreatic cancers are adenocarcinomas, developing in exocrine tissues. Pancreatic cancer is also very difficult to detect in early stages because symptoms are either absent/ nonspecific like:

• Abdominal pain
• Nausea
• Loss of appetite
• Jaundice

Pancreatic Insufficiency

Pancreatic insufficiency is inability of pancreas to produce and/or transport enough digestive enzymes to break down food present in the intestine and allow its absorption. It typically occurs as a result of:

• Progressive pancreatic damage
• Chronic pancreatitis in adults