Acute Pancreatitis - a challenge to overcome!

Surviving Pancreatitis

Acute pancreatitis is an inflammatory disease of the pancreas, in response to an irritant, which leads to a spectrum of symptoms. It usually affects young individuals in the prime of their lives. The two common causes of pancreatitis are alcohol consumption and migration of gall bladder stones into the bile duct. The other causes are hypertriglycidemia, autoimmune pancreatitis, developmental anomalies of the pancreas (pancreas divisum), ingestion of certain drugs and trauma to the pancreas. In 15-20% of all patients, no cause is identified, which is Idiopathic pancreatitis.

Pancreatitis is considered a serious disease due to the havoc it wreaks. Pancreas secrete enzymes that help in digestion of the ingested fats and proteins. In pancreatitis, these enzymes leak out of the pancreas, into the surrounding areas of the pancreas and digest and eat up the tissues around them, resulting in severe necrosis. The seepage of pancreatic juice also damages the wall of the vital structures around the pancreas, thereby resulting in serious complications.

Patients experience severe pain in the upper part of the abdomen, associated with nausea and vomiting. The pain is usually severe, necessitating visits to the emergency room. The diagnosis is primarily clinical, based on the history and typical symptoms, confirmed by a rise in the serum levels of amylase and lipase. Fortunately, 80% of all patients with acute pancreatitis have mild disease, which is self-limiting, and the symptoms resolve in 2-3 days, with medical treatment. Around 20-30% of patients will have repeated attacks of pancreatitis, especially if there is one of the causes mentioned above, and these patients will require treatment of the underlying cause for a cure to pancreatitis.

In 20% of all patients, the disease is severe. Patients showing symptoms of severe disease require hospitalization for treatment and supportive care, during this phase. Severe disease is characterized by unrelenting pain, fever, high heart rate and, occasionally, low blood pressure. In severe disease, any one or more of the other vital organs like cardiovascular (heart) system, respiratory (lung) system, kidneys and liver may be affected. Among the local complications, necrosis of the cells of the pancreas and the surrounding areas, with superimposed infection, is the most serious complication. The onset of any one or more of these complications, incrementally, increases the seriousness of the disease, resulting in a bad outcome.

Acute severe pancreatitis takes a toll on the patient, family, and the treating team. It is a very challenging problem and needs a dedicated team of experts who, in consultation, take the critical decisions to ensure good outcomes for these patients. The patients need ICU care, ventilator and or dialysis support, depending upon the disease situation. Patients with complications may need multiple procedures and surgeries. The course of the disease and treatment often leads to prolonged stay in the hospital, with significant costs. The family and the treating team have to work together to overcome the frustrations and challenges one encounters during the management of this disease.

The Institute of Digestive and HPB Sciences at Sakra World Hospital has launched a "Surviving Pancreatitis Campaign". A Pancreatitis Core Group has been constituted, comprising of specialists with expertise and interest in the disease of the pancreas. The objective of this core group is to provide dedicated, comprehensive care based on standard protocols. A core specialist's group ensures that critical decisions are taken in time and a treatment plan is executed, based on well-established, standard protocols. The Pancreatitis Core Group, a multidisciplinary team, comprises of Surgical gastroenterologists, gastroenterologists, intensive care specialists and radiologists. All patients diagnosed with Acute Pancreatitis, admitted to Sakra World Hospital, are evaluated and managed by the Pancreatitis Core Group. Patients and family are counselled in detail, regarding the status of the patients disease and all treatment decisions and interventions are discussed. One of the key features for a good outcome is a good rapport and relationship of the family with treating doctors.

Pancreatitis Core Group

Surgical Gastroenterology

  • Dr. Sadiq S Sikora
  • Dr. Kishore GSB
  • Dr. Manoj

Medical Gastroenterology

  • Dr. Dinesh Kini
  • Dr. Amrutesh
  • Dr. Sachin Shetty

Intensive case

  • Dr. Anand B. Mamdapur.
  • Dr. Madhusudhan

Radiology

  • Dr. Anisha Tandon
  • Dr. Amitha Vikrama K.S.

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