Pancreatitis is swelling and inflammation of the pancreas. The pancreas is an organ behind the stomach. It makes digestive enzymes and insulin. The digestive enzymes flow into the small intestine to help break down food. Insulin is released into the blood to control the level of sugar in the blood.
Pancreatitis can be acute or chronic. Acute pancreatitis is a sudden attack. After acute pancreatitis, most people recover completely, especially if the disease is diagnosed and treated early enough. Pancreatitis that doesnâ€™t go away or keeps coming back and damages the pancreas is called chronic pancreatitis. About half of the people who have pancreatitis have gallstones blocking the flow of pancreatic secretions into the intestines. This causes the pancreas to swell and hurt. Other causes include drinking alcohol, having high levels of blood fats, the side effects of some medicines, some surgeries, smoking, or an injury to the belly.
What can I expect in the hospital?
You may need to stay in the hospital to:
Control the pain
Correct the cause of the pancreatitis
Prevent further damage to your pancreas
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
You will be checked often by the hospital staff.
Your heart rate, blood pressure, and temperature will be checked regularly.
You may have fingersticks to check blood sugar regularly.
A heart (cardiac) monitor may be used to keep track of your heartbeat.
Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
Your fluid output may be monitored by keeping track of the amount of urine and bowel movements you have. You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
Testing may include:
Blood tests to check your blood sugar and the levels of enzymes made by the pancreas
Urine tests to test for chemicals or enzymes made by the pancreas
Blood, urine, or other tests to monitor how well your organs are functioning
X-rays: Pictures of the inside of the belly and chest to check for gallstones or other problems
Ultrasound scan: Sound waves are used to show pictures of the inside of the pancreas and gallbladder
Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the pancreas and gallbladder
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure in which a thin, lighted tube with a camera (called an endoscope) is passed through your mouth and stomach to your pancreas and intestines to look for gallstones, scar tissue, or other problems that may be blocking the passages (ducts) between the pancreas or gallbladder and intestines. If a problem is found, your provider can often treat it during ERCP.
Magnetic resonance cholangiopancreatography (MRCP): a nuclear medicine study to see if you have gallstones and where they are located
The treatment for pancreatitis depends on its cause, your symptoms, how well you respond to treatment, your overall health, and any complications you may have.
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
You will need to rest your pancreas by not eating or drinking anything for a while.
You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help relieve pressure from air or fluids in your stomach and intestine.
Your provider may prescribe medicines or other therapy to:
Control your blood sugar
Replace enzymes that the pancreas normally makes to help digest food
Treat or prevent an infection
You may need surgery to treat pancreatitis. Surgery may include:
Cholecystectomy: Surgery to remove the gallbladder if gallstones were blocking the duct and causing swelling. This may be done by:
Open cholecystectomy: Surgery to remove the gallbladder through one larger cut in your upper belly
Laparoscopic cholecystectomy: Surgery to remove the gallbladder through several small cuts in the upper belly. Your healthcare provider inserts a lighted tube with a camera (called a laparoscope) through the cut and into your belly to help see and remove the gallbladder.
Debridement: Surgery to remove part of the pancreas that is infected or dead tissue
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure in which a slim, lighted tube with a camera (called an endoscope) is passed through the stomach and into the small intestine and bile duct to check for stones, blockages, or other problems. ERCP may be used in combination with:
Cholelithotomy (gallstone removal): A procedure in which a tiny basket attached to the endoscope is used to remove gallstones that may be blocking the duct
Stent placement: A procedure in which a small metal or plastic hollow device is placed through the endoscope into the pancreatic or bile duct and left there to keep the ducts open
Balloon dilation: A procedure in which a small balloon attached to the endoscope is inflated to widen the pancreatic or bile duct. This may be done with stent placement
Sphincterotomy: A procedure in which your provider makes one or more small cuts in the muscle (sphincter) that controls the flow of bile and digestive enzymes through pancreatic or bile duct to widen the opening
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Abdominal pain that happens along with:
Jaw, arm, shoulder, chest, or back pain
Nausea or vomiting
Shortness of breath
Bowel movement with bright red blood
Abdominal cramps or pain or bloating
Black, tarry bowel movements
Diarrhea, constipation, or other intestinal problems
Frequent or foul smelling bowel movements
Redness, swelling, pain, warmth, or drainage from your surgical wound
Fever, chills, or muscle aches
Swelling in your legs
Ask questions about any medicine or treatment or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital with pancreatitis is 4 to 6 days. Talk with your provider about how long your stay may be.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2015-02-03 Last reviewed: 2014-12-16
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Feldman, M, Friedman, L, & Brandt, L. (2010). Acute Pancreatitis. Sleisenger and Fordtran’s gastrointestinal and liver disease [9th ed.], Ch. 58, 959-983.e6. Philadelphia: Saunders Elsevier.
Goldman, L, & Schafer, A. (2012). Pancreatitis. Goldman’s Cecil medicine [24th ed.], 146, 937-944. Philadelphia: Elsevier Saunders.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp