Pancreatitis Middle-aged male patient presented with nausea, vomiting, and pain in the upper left-hand side of his abdomen. Patient d that the pain became worse after eating high-fat foods or when lying down. Upon discussion, patient admitted to a history of alcohol abuse, as well as elevated triglyceride levels (hypertriglyceridemia) and high cholesterol (hyperlipidemia). Patient has no history of autoimmune disorders, cystic fibrosis, or other genetic conditions. Upon physical examination, the patient was discovered to have a tender mass in his abdomen and a mild fever. Use of the stethoscope revealed an elevated heart and respiratory rate.
Findings suggested an acute case of pancreatitis, so the patient was sent for further testing. Laboratory tests showed elevated blood amylase, serum blood amylase, and urine amylase levels, as well as confirming the patients report of hyperlipidemia and hypertriglycerdemia. An abdominal CT scan returned positive results of an inflammation of the pancreas, and ERCP was used to conclusively confirm the diagnosis of acute pancreatitis. The scan eliminated pancreas divisum as a cause for the condition. CT scan was inconclusive in determining if gallstones have formed as a result of the condition, so an endoscopic ultrasound or ERCP of the gallbladder will be performed.
Patient was admitted to in-patient care and given pain medication and an IV drip. Patient is to take no oral food or drink until the condition improves. If pain increases regardless, nasogastric suctioning is indicated to remove the contents of the stomach and further reduce pancreatic function. Furosemide was prescribed to reduce inflammation. azathioprine is not indicated in this case due to lack of evidence of autoimmune problems. Patients calcium levels should be monitored in case of the patient developing hypercalcemia as a result of the reduced pancreatic and liver function until the pancreatitis attack is resolved.
Prognosis is generally good in this case, as there appears to be no necrotic tissue on the pancreas and there is no evidence of hemmorhaging. However, case must be taken to watch for complications to include kidney failure, respiratory distress, fluid buildup or ascites, and pancreatic pseudocysts, abscesses, or further inflammation.
Patient has been warned to reduce alcohol consumption in the future to reduce the risk of recurrent attack, and to improve his diet to reduce his triglyceride and lipid levels. Repeated attacks increase the possibility of acute pancreatitis becoming chronic. Eventually, scarring of the pancreas can lead to damage in areas of the pancreas that produce insulin, leading to diabetes.