Pancreas and Bile Tract Diseases

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Pancreas and Bile Tract Diseases

Primary diseases of the pancreas can be classified into acute and chronic pancreatitis and pancreatic cancer.


Pancreatitis is an inflammation of the pancreas. It occurs when digestive enzymes from the exocrine pancreas become active in the pancreas instead of the duodenum and begin to “digest” the pancreas. They usually occur with abdominal pain and can cause nausea and vomiting.

Acute pancreatitis occurs as a single or recurring event and usually occurs suddenly. Severe abdominal pain is often present in acute pancreatitis. In fact, the disease can lead to internal bleeding and infection and can be life-threatening. The most common cause of acute pancreatitis is blockage of the pancreatic duct with gallstones. Secretions can accumulate in the pancreas and cause permanent damage within a few hours. In acute pancreatitis, pancreatic enzymes are often elevated in the blood. These enzymes can travel to other organs of the body and cause shock and organ failure. Other causes may include biliary tract disease (obstruction, gallstones, or sludge), excessive alcohol use, physical trauma to the abdominal area, hyperlipidemia, and hypercalcemia.

Chronic pancreatitis is characterized by chronic or persistent abdominal pain and pancreatic enzymes may or may not be elevated. Chronic pancreatitis develops gradually, often causing progressive destruction of the pancreas and can lead to other problems such as pancreatic insufficiency (see below), bacterial infections and type 2 diabetes. The main causes of chronic pancreatitis are gallbladder disease (duct obstruction) and alcoholism. Other causes of chronic pancreatitis include cystic fibrosis, hypercalcemia, hyperlipidemia, certain medications, and autoimmune diseases.

Pancreatic Cancer

Pancreatic cancer risks include smoking, age, gender (more common in men), chronic pancreatitis, and exposure to some industrial chemicals. Most pancreatic cancers (% 95) are adenocarcinomas that develop in exocrine tissues. It is very difficult to diagnose pancreatic cancer in the early stages because it is asymptomatic or has nonspecific symptoms such as abdominal pain, nausea, loss of appetite and sometimes jaundice. Only about of cancers remain within the pancreas at diagnosis and have not spread.

Pancreatic Insufficiency

Pancreatic insufficiency is the loss of the ability of the pancreas to produce and/or transport sufficient amounts of enzymes necessary to break down nutrients in the intestines and allow them to be absorbed. It typically occurs as a result of progressive pancreatic damage that can be caused by various conditions. It is most often associated with cystic fibrosis in children and chronic pancreatitis in adults. It is less frequently associated with pancreatic cancer.

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