Conditions & Treatments

Pancreatitis

Pancreatitis is the inflammation of the pancreas. The inflammation may be sudden (acute) or ongoing (chronic).

Pancreatitis

What is pancreatitis?

Pancreatitis is the inflammation and autodigestion of the pancreas. Autodigestion describes a process whereby pancreatic enzymes destroy its own tissue leading to inflammation. The inflammation may be sudden (acute) or ongoing (chronic). Acute pancreatitis usually involves a single "attack," after which the pancreas returns to normal. Severe acute pancreatitis can be life threatening. In chronic pancreatitis, permanent damage occurs to the pancreas and its function, often leading to fibrosis (scarring).

What causes pancreatitis?

The most common causes of pancreatitis include the following:

  • Gallstones that block the pancreatic duct

  • Alcohol abuse, which can lead to blockage of the small pancreatic ductules

Other causes of pancreatitis include the following:

  • Abdominal trauma or surgery

  • Kidney failure

  • Lupus

  • Infections, such as mumps, hepatitis A or B, or salmonella

  • Cystic fibrosis

  • Presence of a tumor

  • A venomous sting from a scorpion

What are the symptoms of pancreatitis?

The following are the most common symptoms of pancreatitis. However, each individual may experience symptoms differently. Symptoms may include:

  • Abdominal pain that may radiate to the back or chest

  • Nausea

  • Vomiting

  • Rapid pulse rate

  • Fever

  • Swelling in the upper abdomen

  • Ascites. Fluid buildup in the abdominal cavity.

  • Dropping blood pressure

  • Mild jaundice. A yellowing of the skin and eyes.

Severe abdominal pain in the upper abdomen is usually a symptom of acute pancreatitis. The symptoms of pancreatitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is pancreatitis diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for pancreatitis may include the following:

  • Abdominal X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Various blood tests

  • Ultrasound (also called sonography). A diagnostic imaging technique which uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys, and to assess blood flow through various vessels.

  • Endoscopic retrograde cholangiopancreatography (ERCP). A procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope, which is a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum. The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an X-ray.

  • Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.

  • Magnetic resonance cholangiopancreatography (MCRP). A test that produces images of body parts by injecting dye into a patient's veins that helps show the pancreas, gallbladder, and pancreatic and bile ducts.

Treatment for pancreatitis

Specific treatment for pancreatitis will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance of specific medicines, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

The overall goal for treatment of pancreatitis is to rest the pancreas and allow it to recover from the inflammation.

Treatment may include:

  • Hospitalization for observation and intravenous (IV) feeding

  • Endoscopic retrograde cholangiopancreatography (ERCP)

  • Surgery

  • Antibiotics

  • Avoiding alcohol (if the pancreatitis is caused by alcohol abuse)

  • Pain management

  • Frequent blood tests (to monitor electrolytes and kidney function)

  • No food by mouth for several days

  • Bed rest or light activity only

  • Placement of a nasogastric tube (tube inserted into the nose that ends in the stomach)

Individuals with chronic pancreatitis may also require:

  • Enzyme supplements to aid in food digestion

  • Insulin (if diabetes develops)

  • Small high-protein meals

  • Medications (for example, H2-blockers) to decrease gastric acid production in the stomach

Acute pancreatitis is self-limiting, meaning it usually resolves on its own over time. Up to 90 percent of individuals recover from acute pancreatitis without any complications. Chronic pancreatitis may also be self-limiting, but may resolve after several attacks and with a greater risk of developing long-term problems, such as diabetes, chronic pain, diarrhea, ascites, biliary cirrhosis, bile duct obstruction, or pancreatic cancer.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



Digestive Healthcare Center

  • Pancreas and Biliary Center
    The Pancreas and Biliary Center at the Massachusetts General Hospital Digestive Healthcare Center provides patients with specialized options for the detection, diagnosis, treatment and management of pancreatic and biliary diseases.
Imaging

  • Pediatric Imaging
    The Pediatric Imaging Program at Massachusetts General Hospital Imaging specializes in ensuring the safety and comfort of child patients while providing the latest technology and the expertise of specialized pediatric radiologists.
  • Adult Medicine Imaging
    The Adult Medicine Imaging Program at Massachusetts General Hospital Imaging offers a wide range of diagnostic exams and minimally invasive, image-guided treatments, all provided using leading-edge equipment and interpreted by specialty-trained radiologists.
MassGeneral Hospital for Children

  • Pediatric Transplant Surgery
    The Pediatric Transplant Program at MassGeneral Hospital for Children is a major referral center for organ transplants for children.
  • Pediatric Hepatobiliary and Pancreatic Program
    The Pediatric Hepatobiliary and Pancreatic Program at MassGeneral Hospital for Children diagnoses and treats infants, children and adolescents with diverse hepatic, biliary and pancreatic disorders.
Gastroenterology

  • Pancreas and Biliary Program
    The Pancreas and Biliary Program at the Gastroenterology Division of Massachusetts General Hospital provides patients with specialized options for the diagnosis, treatment and management of pancreatic and biliary diseases.
General and Gastrointestinal Surgery

  • Pancreas and Biliary Surgery Program
    Mass General's Pancreas and Biliary Surgery Program provides surgical treatments for diseases of the pancreas, gall bladder, liver and bile ducts.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Introducing Keith D. Lillemoe, MD

MGH Hotline 5.13.11 Keith D. Lillemoe, MD, the MGH's new surgeon-in-chief and chair of the Department of Surgery, spent 27 years at Johns Hopkins and most recently led the Department of Surgery at Indiana University Hospital.

Innovative care at the Digestive Healthcare Center

Learn more about the latest treatment options for this condition at the Digestive Healthcare Center