What is the prognosis of severe pancreatitis?
OverviewWhen your pancreas is inflamed, you'll feel pain in your upper abdomen that can extend to your back.What is pancreatitis?Pancreatitis is an inflammation (swelling) of the pancreas. When the pancreas is inflamed, the powerful digestive enzymes it makes can damage its tissue. The inflamed pancreas can cause release of inflammatory cells and toxins that may harm your lungs, kidneys and heart. Show
There are two forms of pancreatitis:
Where is the pancreas located?The pancreas is an organ in the upper abdomen (belly). It connects to the beginning of the small intestine (the duodenum). It contains the pancreatic duct (tube), which drains digestive enzymes (chemicals) into the small intestine (the duodenum). What is the function of the pancreas?Your pancreas has two primary functions. First, it makes digestive enzymes (chemicals) and releases them into the small intestine. These enzymes break down carbohydrates, proteins and fat from food. Your pancreas also produces several hormones and releases them into the blood. Amongst these hormones is insulin which regulates the amount of sugar in your blood (glucose). Insulin also helps provide energy now and stores some for later. Who gets pancreatitis?You’re more likely to develop pancreatitis if you:
Symptoms and CausesWhat causes pancreatitis?Gallstones or heavy alcohol drinking are usually the cause of pancreatitis. Rarely, you can also get pancreatitis from:
What are the symptoms of pancreatitis?Pancreatitis symptoms vary, depending on the type of condition: Acute pancreatitis symptoms If you have acute pancreatitis, you may experience:
Chronic pancreatitis symptoms Chronic pancreatitis may cause some of the same symptoms as acute pancreatitis. You may also develop:
Diagnosis and TestsHow is pancreatitis diagnosed?Your provider may suspect pancreatitis based on your symptoms or risk factors, such as heavy alcohol use or gallstone disease. To confirm diagnosis, you may go through additional tests. Diagnosing acute pancreatitis For acute pancreatitis, your provider may order a blood test that measures the levels of two digestive enzymes (amylase and lipase) produced by the pancreas. High levels of these enzymes indicate acute pancreatitis. An ultrasound or computed tomography (CT scan) provides images of your pancreas, gall bladder and bile duct that can show abnormalities. Diagnosing chronic pancreatitis Diagnosing chronic pancreatitis is more involved. You may also need:
Management and TreatmentHow is pancreatitis treated?If you have pancreatitis, your primary care provider will probably refer you to a specialist. A doctor who specializes in the digestive system (gastroenterologist) should oversee your care. Doctors use one or more of these methods to treat acute pancreatitis:
Procedures used to treat pancreatitis Most pancreatitis complications like pancreatic pseudocyst (type of inflammatory cyst) or infected pancreas tissue are managed through endoscopic procedure (inserting a tube down your throat until it reaches your small intestine, which is next to your pancreas). Gallstones and pancreas stones are removed with an endoscopic procedure. If surgery is recommended, surgeons can often perform a laparoscopic procedure. This surgical technique involves smaller cuts that take less time to heal. During laparoscopic surgery, your surgeon inserts a laparoscope (an instrument with a tiny camera and light) into keyhole-sized cuts in your abdomen. The laparoscope sends images of your organs to a monitor to help guide the surgeon during the procedure. PreventionCan pancreatitis be prevented?The best way to prevent pancreatitis is to have a healthy lifestyle. Aim to:
These healthy lifestyle choices will also help you avoid gallstones, which cause 40% of acute pancreatitis cases. Your provider may recommend removing your gallbladder if you have painful gallstones multiple times. Outlook / PrognosisHow long does pancreatitis last?Typically, acute pancreatitis lasts only a few days. But if you have a more severe case, it may take several weeks to months to recover. Chronic pancreatitis requires lifelong management. Will pancreatitis go away?With treatment, most people with acute pancreatitis completely recover. Chronic pancreatitis is a long-lasting condition. Once it’s severely damaged, your pancreas doesn’t function properly. You need ongoing support to digest food and manage blood sugar. Can pancreatitis return?With chronic pancreatitis, painful episodes can come and go or persist (last a long time). You can also have another attack of acute pancreatitis, especially if you haven’t resolved the underlying problem. For example, if you have another gallstone that blocks the opening to the pancreas, you can get acute pancreatitis again. Is pancreatitis fatal?Most people with a mild case of acute pancreatitis fully recover. However, those with severe pancreatitis are more likely to have life-threatening complications such as:
Living WithHow should I take care of myself after having pancreatitis?You can take several steps to prevent another pancreatitis attack:
What should I ask my doctor?If you have pancreatitis, you may want to ask your doctor:
A note from Cleveland Clinic Pancreatitis is painful, but in the majority, treatments coupled with lifestyle changes can help you make a full recovery and prevent further acute pancreatitis episodes. While chronic pancreatitis doesn’t go away, you can manage the symptoms and avoid complications with help from your doctor. What are the chances of surviving severe pancreatitis?Mild acute pancreatitis has a very low mortality rate (less than 1 percent),1,2 whereas the death rate for severe acute pancreatitis can be 10 to 30 percent depending on the presence of sterile versus infected necrosis.
Is severe pancreatitis fatal?When this happens, the pancreas can become infected, which can spread into the blood (sepsis) and cause organ failure. People with necrosis and an infection may need injections of antibiotics and surgery to remove the dead tissue. This is a very serious complication that needs treating, and it can be fatal.
When is pancreatitis considered severe?APACHE-II score of 9 or more is considered as severe pancreatitis. APACHE score can be observed during the course of acute pancreatitis. The disease is assumed as severe acute pancreatitis when the score is 3 or more.
What is the most common cause of death in severe acute pancreatitis?SAP remains a serious medical problem. Effective control of early MOF and treatment of systemic complications associated with the infected necrosis require innovative strategies. In conclusion, approximately half (42%) of SAP deaths occur within two weeks and most are due to multiple organ failure.
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