Causes and Diagnosis of Pancreatitis
It is caused by gall bladder stones or after a binge of alcohol drinking. Sometimes, no cause may be found. Rarely, scorpion bites, certain drugs like azathioprine (used in post transplant for immuno-supression), endoscopic procedures like ERCP (Endoscopic Retrograde Cholangio-Pancreatogram) may also trigger an attack of pancreatitis. Viral infections due to coxsackie, bacterial infections due to mycoplasma or worms like ascaris can block the pancreatic duct causing pancreatitis.
In 1899 Fitz described three types of pancreatitis depending on the severity of the inflammation and damage to the organ and classified them as - Hemorrhagic, suppurative and Gangrenous.
Diagnosis:
Pancreatitis can be diagnosed by the typical history, and confirming these with a few tests.
- A blood amylase level if elevated is highly suggestive of acute pancreatitis. During an attack of pancreatitis it may be raised to three times above its normal value. Likewise other blood parameters like glucose, calcium, lipase, and other electrolytes may help point to a diagnosis of acute pancreatitis.
- A WBC count may show an elevated cell count
- CT scan can reveal swelling, cysts, damage to the gland and so on.
- Liver function test may have to be done in addition when a gall stone pancreatitis is suspected to ascertain the state of the liver.
- Ultrasound of the abdomen is also useful in diagnosing a calculus in the gall-bladder or the biliary tract and also to see the presence of free fluid in the abdomen.
