Acute pancratitis: what are the symptoms and how to treat it?

Verified on 04/01/2024 by Alexane Flament, Editor

Acute pancreatitis is the acute inflammation of the pancreas. It settles in a few hours or a few days at most. In 80% of cases, it resolves spontaneously. However, treatment is necessary to relieve the symptoms.

The main symptom of acute pancreatitis is severe pain that appears suddenly in the center of the abdomen. This strong pain intensifies over hours and radiates towards the back.

Other symptoms may occur in acute pancreatitis:

nausea and vomiting;
indigestion;
fever (temperature above 38°C);
jaundice (the whites of the eyes and skin turn yellow);
swelling of the stomach;
an increase in heart rate (tachycardia) and breathing.

These symptoms tend to get worse after drinking or eating, especially fatty foods. Certain positions can also accentuate symptoms.

The pain is worse if you lie on your back. On the other hand, relief may be felt if you lean forward while sitting.

All patients with pancreatitis should be hospitalized. Treatment is essentially symptomatic. The priority is to reduce pain.

Patients receive analgesics, generally high doses of parenteral opiates (intravenous or intramuscular), and antiemetics to stop nausea and vomiting.

To avoid dehydration (prompted by vomiting), an infusion of saline and glucose serum is started upon treatment.

The weakened pancreas must, moreover, be put to rest. For this, a fast is imposed until the pain disappears. Resumption of oral nutrition is possible after 48 hours without pain, provided that transit has resumed.

If the cause of pancreatitis is the presence of a gallstone that does not pass spontaneously, this is removed endoscopically and the gallbladder must be removed once the inflammation in the pancreas has subsided.

In case of severe pancreatitis, the patient is placed in intensive care because the risk of death is high (greater than 30%). He is fed through a tube that delivers nutrients directly to the small intestine.

Severe pancreatitis can lead to necrosis of part of the pancreas. If this necrosis becomes infected, it must be drained using endoscopic or radiological drains or prostheses.