Complications of Pancreatitis
An important organ in the digestive system, the pancreas is 6 to 8 inches in length and situated behind the stomach. The pancreas produces enzymes that aid in the digestion of food as well as hormones that help regulate blood sugar levels.
When the pancreas is injured, pancreatitis, or inflammation of the pancreas, can develop. Sometimes this can cause a blockage in the pancreatic ducts (drainage tube) that carry the enzymes, resulting in the formation of a pseudocyst, or fluid-filled cavity. More severe cases can result in necrotizing pancreatitis, in which a cavity develops either inside or outside of the pancreas and is filled with both liquid and solid material, known as necrotic debris.
The Orlando Health Digestive Health Institute’s team of specialists offers patients advanced care, with leading-edge procedures to heal the pancreas and provide relief from symptoms of pancreatitis, such as abdominal pain.
Common causes of pancreatitis, which can result in pseudocysts or walled-off necrosis (WON), include alcohol use, gallstones, trauma to the pancreas, some medications and high cholesterol (triglycerides). In 5 percent to 20 percent of cases, no cause for pancreatitis can be found.
Common causes of pancreatitis, which can result in pseudocysts or walled-off necrosis (WON), include alcohol use, gallstones, trauma to the pancreas, some medications and high cholesterol (triglycerides). In 5 percent to 20 percent of cases, no cause for pancreatitis can be found.
Symptoms of Pancreatic Pseudocyst and WON
- Abdominal pain
- Fever
- Nausea
- Vomiting
- Loss of appetite
- Weight loss
- Fatigue (tiredness)
- Diarrhea
- A tender mass in the abdomen
- Yellowing of the skin and/or eyes (jaundice)
Endoscopic Ultrasound (EUS)
During an EUS procedure, a thin tube called an endoscope is inserted through the mouth and guided into the stomach and to the small intestine (duodenum). An attached ultrasound device is used to locate the fluid-filled cavity in the pancreas. Once located and evaluated, your doctor will puncture the wall of the cavity and insert a plastic or metal stent to drain the fluid from the cavity into the stomach. After 3-6 weeks, depending on the type of stent used, you will have a follow-up CT or MRI scan to confirm that the cavity is significantly smaller or completely gone, and then the stent will be removed. In cases where there is permanent damage to the pancreatic duct, the stent may be left in. Your doctor will make this determination upon follow-up.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
In an ERCP procedure, your doctor will inject dye through the endoscope to evaluate if there is any damage to the pancreatic duct. If your doctor finds a leak, a stent will be placed in the pancreatic duct to allow the area to heal. The stent prevents recurrence of the fluid-filled cavity. This stent is not permanent and will be removed at the time of follow-up.
Feeding Tube
Every time you eat, your pancreas produces juices (enzymes) to digest the food. While this process is necessary, it can worsen your pancreatitis and make it more difficult for the pancreas to heal. In this instance, your doctor may decide that you need a temporary feeding tube known as a PEG-J to allow the pancreas to rest and recover. The PEG-J feeding tube is placed in your small intestine and ensures that your body gets adequate nutrition. You may be allowed to drink clear liquids and can continue with most of your daily activities while the feeding tube is in place. You will have a follow-up appointment in 3-6 weeks at which time the feeding tube will be removed as long as you are feeling better with no pain.
Surgery
Although rare, surgery is sometimes necessary to remove the buildup of fluid in the pancreas. After accessing the pancreas through an incision in your abdomen, your surgeon will drain the fluid-filled cavity into the stomach or out through the open incision.
Radiology
In some cases, a CT scan can be used to guide placement of a drainage device in the pancreas. However, this treatment may not be a permanent remedy, and endoscopy or surgery may still be required.
