Pancreatitis Management

Patients may develop pancreatitis after undergoing an endoscopic retrograde cholangiopancreatography, or ERCP. Symptoms of pancreatitis after ERCP typically become present within a few hours after the procedure is complete. Pancreatitis after ERCP primarily manifests as severe abdominal pain. Patients will often experience back pain, mild fever, and nausea which may be accompanied by vomiting.

Managing Pancreatitis

Currently, there is no set protocol for pancreatitis management. Pancreatitis management depends on the patient’s symptoms and the severity of the condition. Mild pancreatitis management is less intensive, as mild pancreatitis typically does not cause complications. However, severe pancreatitis management may involve the treatment of resulting complications. In cases of severe pancreatitis, hospitalization and constant care are required. If the patient fails to receive adequate medical attention and pancreatitis management, death may occur.

Diagnosing Pancreatitis

If the patient experiences pancreatitis symptoms, the medical professional should perform testing confirm the diagnosis. Once the condition is confirmed, pancreatitis management can begin.

Cross Sectional Imaging

Computed tomography (CT) or magnetic resonance imaging (MRI) may be used in pancreatitis management and diagnosis. These imaging tests may reveal an inflamed and enlarged pancreas. CT may also be used to determine other conditions, such as organ perforation, hemorrhage, infection, and development of abscesses.

Blood Testing

Pancreatitis can be observed when a patient experiences drastic increases in the levels of pancreatic enzymes. Blood testing during pancreatitis management will reveal that patients have three times the normal amounts of lipase or amylase. Lipase and amylase are digestive enzymes made in the pancreas.

Mild Pancreatitis Management

Pancreatitis management for mild forms may be performed in a general hospital setting. Since the digestive process places stress on the pancreas, eating should be avoided until the inflammation has resolved. On average, this takes roughly five days. Intravenous (IV) fluids may also be administered to ensure adequate hydration.

In some cases, pancreatitis may cause lung damage or abnormal lung function. To prevent lung complications, oxygen tubes may be inserted through the patient’s nose. Morphine or other opiate-based painkillers may be given to manage pain.

Severe Pancreatitis Management

Severe pancreatitis is estimated to occur in roughly two-to-three percent of patients who develop pancreatitis after ERCP. Patients with severe pancreatitis after ERCP should undergo pancreatitis management and monitoring in an intensive care hospital environment or other high-dependency medical environment. Patients who exhibit dysfunction of multiple organs as a result of pancreatitis have a 20-to-40 percent mortality rate.

Aggressive hydration through IV, electrolyte balance maintenance, and nutritional support are recommended for severe pancreatitis management. Antibiotics and anti-inflammatory medicines such as non-steriodal anti-inflammatory drugs (NSAIDs) may be administered to reduce inflammation and fight possible infection. Similarly to mild pancreatitis management, oxygen tubes may be used to prevent lung damage and painkillers may be administered.

Sources:

Badalov, Nison, et al. “The Prevention, Recognition and Treatment of Post-ERCP Pancreatitis.” Journal of the Pancreas. 10.2 (2009): 88-97. Web. 27 Jun. 2013. <http://www.joplink.net/prev/200903/200903_25.pdf>.

Baillie, John. “Management of Post-ERCP Pancreatitis.”Gastroenterology & Hepatology. 7.6 (2011): 390-392. Web. 27 Jun. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151411/>.

Bhasin, Deepak, et al. “Protocol-based Management Strategy for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Can It Make a Difference?” Journal of Gastroenterology and Hepatology. 23.3 (2008): 344-347. Web. 27 Jun. 2013. <http://www.medscape.com/viewarticle/575149>.

Pannu, Harpreet, and Elliott Fishman. “Complications of Endoscopic Retrograde Cholangiopancreatography: Spectrum of Abnormalities Demonstrated with CT.” RadioGraphics. 21. (2001): 1441-1453. Web. 27 Jun. 2013. <http://radiographics.rsna.org/content/21/6/1441.full>.