Acute pancreatitis

pancréatite aiguëDefinition

Acute pancreatitis is an inflammatory disease of the pancreas. There are two types: the first, benign, is oedematous in 75% of cases and the second, necrotizing (15 to 25% of cases), is much more serious. In its necrotizing form, this condition causes significant mortality. The two main causes of acute pancreatitis are biliary lithisase and chronic alcoholism.

Epidemiological data

It is a rare disease: there are 5 cases per year in France. It can appear at all ages. Acute biliary pancreatitis mostly affects women between the ages of 000 and 60, while for acute alcoholic pancreatitis, it is mostly men between 65 and 40 years old.

Symptoms of the disease

Patients with acute pancreatitis suffer, in 95% of cases, from intense and constant abdominal pain. They are often accompanied by nausea and vomiting, which rarely provide relief. Only the "gun dog" position - or the compression of the epigastric region - can reduce pain.

Treatments

• Drug treatment uses analgesics, sometimes morphine, to relieve pain and antibiotics to prevent infections.
• Endoscopic and surgical treatment :
- for biliary pancreatitis, endoscopic sphincterotomy significantly reduces mortality. As for biliary surgery, it allows the complete treatment of the lithiasis ;
- for pancreatic lesions, surgery is contested. In the absence of infection, surgery is not performed, even if the patient's condition deteriorates.