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Pancreatitis and appendicitis – silent enemies

Posted on 24-11-2020

Santa Cruz de Tenerife, November 24. The Hospiten Group warns of the importance of going to the E.R. in the case of certain symptoms caused by pancreatitis and appendicitis, which must not be ignored due to the risks they pose.

Dr. Gianluca Cherubino, the Head of the General Surgeon and Digestive System at Hospiten Sur explains that the pancreas is an extraordinary organ with functions that include the endocrine system, with the production of hormones, like insulin and the production of enzymes the help digestion (the exocrine function), like amylase, lipase and trypsinogen and so on.

"The pancreas is located behind the stomach and joins the duodenum through the pancreatic duct, where it drains enzymes and pro-enzymes that activate and digest food and because they are so important to the functioning of the body have always been of great interest in medical studies,” he comments.

The pancreas can be affected in several ways, the most common being pancreatitis, which is where the organ is suffers a lesion and inflammation resulting in self-digestion (its enzymes destroy its own tissue). There are two types: acute pancreatitis, which is one episode and chronic pancreatitis that has already become a repetitive condition and over a longer period of time which can lead to irreversible damage, where the functions of the organ are partially or completely lost. Some of the damage of chronic pancreatitis are manifested by malabsorption of food and malnutrition, diabetes mellitus, pancreatic fistulas, pancreatic pseudocyst, and if the organ ruptures, pancreatic ascites.

The most common causes are alcohol abuse and obstruction due to gallstones. The consumption of fatty foods, trauma, steroids, the mumps virus, cancer, autoimmune pancreatitis, elevated triglycerides, high calcium levels, certain medications (reverse transcriptase inhibitors, and protease inhibitors).

The main symptom is sudden, severe pain in the upper abdomen that radiates to the back, almost always accompanied by nausea and vomiting. The pain is relieved by leaning forward. The condition can manifest itself in a mild or severe form where there is shock and multiple organ failure. "If you have any of these symptoms, you must go to the emergency room immediately," states Dr. Cherubino. Once in the emergency room, tests will be performed to confirm the clinical suspicion, serum amylase and lipase, in addition to ultrasound and tomography.

Treatment varies with the degree of severity at the time of diagnosis, and consists of intravenous hydration, fasting or intestinal rest, analgesics avoiding morphine, with close hospital monitoring, where parameters that help estimate the patient’s evolution and prognosis are evaluated.

As final recommendations, Dr. Cherubino indicates that "to recover the patient must eat small portions, avoid fatty foods and alcohol, since in patients with chronic pancreatitis alcohol cannot be ingested, and they must take pancreatic enzymes in the form of supplements to avoid malabsorption and steatorrhea, and glycemia must be monitored because there is a risk of diabetes mellitus”.

On the other hand, appendicitis (inflammation of the vermiform appendix) is caused by the obstruction of the appendicular lumen, either by a fecalith (hardened feces) or in the case of children by the growth of tissue called lymphoid hypertrophy.

The main symptom is abdominal pain, whose evolution and characteristics help the diagnosis. This is accompanied by nausea, vomiting, loss of appetite and a high temperature. The specialist explains that in this case the patient must go to the emergency room immediately, especially if the symptoms persist for more than an hour.

"It is estimated that 10% of the population will suffer from acute appendicitis and it is the most common cause of emergency abdominal surgery," says Dr. Cherubino. It is more common in young people, including adolescents, but, it can occur at any age.

A possible complication is the perforation of the appendix, which is serious and requires immediate medical care. This occurs mainly in children and the elderly. For this reason, doctors insist on the need to go to the emergency room and for medical specialists to confirm the diagnosis and treat the condition immediately.