A Simple Guide to Pancreatitis

A Simple Guide to Pancreatitis
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What is Pancreatitis?
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Pancreatitis is an acute or chronic inflammation of the pancreas.

What are the causes of Pancreatitis?
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Pancreatitis is usually caused by the following:

1. Alcoholism and diseases of the biliary tract

2. bacterial infections from salmonella typhi and streptococcus

3. viral infection especially mumps, coxsackie virus, cytomegalovirus

4. trauma

Chronic disease follows attacks of acute infection.

What are the symptoms and signs of Pancreatitis?
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Persons who has Acute Pancreatitis has the following symptoms:

1.acute onset of abdominal pain starting from the epigastrium, radiating to the back in 50% of cases.

2.Pain usually very severe occuring a large meal or drinking bout

3.Pain is worse lying supine, therefore patients sit or lean forward

4.mild fever and bodyaches

5.nausea and vomitting

6.hypotension followed by clinical shock

Signs:

1.Tenderness at the epigastrium with muscle spasm

2.Distension and diminished bowel sounds

3.Pleural effusion 10%,abdominal mass 20%, ascites 20%

4. Acute renal failure, respiratory failure following shock.

Chronic Pancreatitis
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Symptoms:

1.repeated attacks of epigastric abdominal pain

2.Pain worse after eating, radiates to the back

3.weight loss

4.Fever

Signs:

1.abdominal tenderness

2.abdominal mass may suggest swelling and pseudocysts

3.tender subcutaneous masses seen indicating fat necrosis

How do you diagnose Pancreatitis?
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Diagnosis can usually be made by :

1.Physical examination with tenderness in the epigastrium

2.Serum and urine amylase very high after 6 hours

3.White blood cell count high

4.Serum lipase high in 50% patients

5.Blood calcium may be low

6.Blood glucose tolerance test for diabetes

7.Ultrasound may show up the presence of pseudocyst in pancreas

8.CAT scan and MRI may show swelling and pseudocysts in pancreas

What is the complications of Pancreatitis?
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1.Pseudocysts from damage to pancreatic tissues

2.Hemorrhage - bleeding due to damage to the blood vessels in pancreas

3.peritonitis from rupture of pseudocysts and bleeding

4.diabetes mellitus from damage to the glands in the pancreas producing insulin

What is the treatment of Pancreatitis?
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Acute Pancreatitis:
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Admission to hospital

Gastric suction and fluid replacement

Analgesic or antispasmodic medicine usually by injection

Antibiotics for infections

Treat biliary tract diseases and alcoholism

surgical drainage of pseudocysts after acute episode.

Chronic Pancreatitis:
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Pancreatic extracts and enzymes together with meals

Sodium bicarbonate and cimetidine to prevent enzymes breakdown

Analgesic or antispasmodic medicine usually by injection

Surgical procedures usually unsuccessful

What is the prognosis of Pancreatitis?
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Prognosis is usually good after treatment of acute pancreatitis with recovery in 5-7 days.

Hemorhagic Pancreatitis has high mortality of 50-90%

Most trauma cases has complete resolution

Some alcoholic pancreatitis may go on to chronic pancreatitis.

Chronic pancreatitis relapses frequently

Rupture of pseudocysts may result in death

How do you prevent Pancreatitis?
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Avoid alcohol and oily food

Take precautions during mumps and other viral infection

Avoid injury to the abdomen especially the mid section below the sternum

A Simple Guide to Mumps

A Simple Guide to Mumps
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What is Mumps?
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Mumps is a highly contagious viral infection that causes painful swelling in the salivary glands (the glands which produce saliva) which include the parotid, submandibular and submental glands.

How is Mumps spread?
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The mumps (paramyxovirus) virus is spread by coughing, sneezing and through the saliva of an infected person.

It can also be spread by contact with contaminated items and surfaces.

It is contagious 1 - 2 days before the appearance of symptoms to 1 - 2 days after the symptoms disappear.

The incubation period is about 18 days.

An attack gives lifelong immunity.

Who is infected in Mumps?
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Although mumps may affect adults, children between the ages of 5 - 15 years are most prone.

What are the Symptoms of Mumps?
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Symptoms
1.Prodromal symptoms such as fever, headache and sore throat

2.Facial pain and swelling

3.pain or lumps in their testicles

4.Abdominal pain

Signs:
1.Swollen and tender parotid glands in front of the ear, cheek and neck.
Submandibular glands below the jaws are less affected

2.Dry mouth - less saliva ,fever

3.Males may experience pain or lumps in their testicles, and swelling in the scrotum. However this rarely causes infertility problems.

4.Pain in the abdomen may indicate pancreatitis, a rare complication

5.Meningoencephalitis (infection of the central nervous system) with fever, headache and neck rigidity. It usually does not cause permanent damage.

What is the Treatment of Mumps?
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Mumps is a viral disease and cannot be cured.
It normally run its course within 1 week.
Treatment of mumps is therefore symptomatic.

1.Rest and soft diet.

2.Lots of fluids

3.Paracetamol can be given to reduce fever and relieve pain. For children, aspirin should not be given because of the risk of Reye's syndrome which can damage the brain.

4.Warm or cold compresses can be given to relieve pain and swelling in the parotid glands.

5.Cool compresses and scrotal support can be given to reduce pain and swelling in the testicles.

6.Avoid foods that stimulate the parotid glands (stimulating the glands causes pain) such as fruit juices and tart beverages.

What are the complications of Mumps?
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The mumps virus may affects many different glands including the brain.
It can affect the testes (orchitis)in boys or ovaries (oophoritis) in girls during puberty rarely causing infertility.

It can also affect the pancreas in some patients giving rise to Juvenile Diabetes or pancreatitis.

In the brain rarely encephalitis or meningitis may occur with damage to some brain cells.

What is the prognosis of Mumps?
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Prognosis is good in all cases.
Very rarely do complications such orchitis or meningitis occur.

How is Mumps Prevented?
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Mumps can be prevented by administering the Mumps, Measles, Rubella vaccine (MMR). This vaccine is given at the age of 15 months and again at 12 years old.