By: Mark Benjamer R.

Carganilla
 a elongated gland organ in the digestive and
endocrine that lies in the back of the mid-
abdomen

 Functions:
◦ Production of insulin, glucagon, and
somatostatin
◦ Secretion of pancreatic juice containing
digestive enzymes that help in the further
breakdown of carbohydrates, protein, and fat in
the chyme.
 Ninety-nine percent of pancreatic tissue is
composed of acinar glands, which secrete an
alkaline digestive juice into the duodenum via the
pancreatic duct to help digest food.
 The endocrine areas of the pancreas, known as
the islets of Langerhans, are composed of two
major types of cell.
 The alpha cells secrete the hormone glucagon,
and
 Beta cells make and release insulin, a hormone
that controls the level of glucose in the blood.
 Insulin promotes the uptake and usage of glucose
in the tissues, particularly skeletal muscle and
fat, and reduces glucose production in the liver.
 Glucagon has an anti-insulin effect in the liver,
increasing glucose release.
 The anatomy of the pancreas also includes: the
ampulla of the common bile duct: the
 pancreatic duct, which carries digestive juice

containing enzymes to the duodenum;

 The acini, the exocrine portions of the

pancreas which secrete digestive juice into the

pancreas.
 the splenic arteries which conduct

oxygenated blood into the pancreas; and

 the mesenteric veins, which carry

deoxygenated blood containing insulin and

glucagon away from the pancreas.
 An inflammation of the pancreas with associated
escape of pancreatic enzymes into the
surrounding tissues.

 Types:
◦ Acute Pancreatitis: occurs suddenly as one
attack and can b recurrent with resolutions.
◦ Chronic Pancreatitis: a continual inflammation
and destruction of the pancreas, with scar
tissue replacing pancreatic tissue.
Its not clear but it appears that the digestive
enzymes normally secreted by the pancreas in
inactive form become activated in side the
pancreas, and this start a digestive process of
the pancreatic tissue so called Auto
digestion
 An digestive enzymes start building up and

attack the pancreas itself, this problem gives

rise to Pancreatitis.
Its cause swelling hemorrhage and severe
damage in the pancreatic area.
Pathophysiology
 Trauma
 Alcohol use
 Biliary tract disease
 Hyperlipidemia
 Hypercalcemia
 Cholelithiasis
 Hyperparathyroidism
 Ischemic vascular disease
 Peptic ulcer disease
 Age 40-45 y/o. with History of Alcoholism
(men)
 50-55 y/o. with History of biliary disease

(women)
 Genetics
 Drugs: use of steroids, diuretics and uses of

oral contraceptives.
 Obesity
 Viral infections (Coxsackie Virus)
 Pancreatic Duct Obstruction

Reflux of Bile From the duodenum

Activation of Trypsin and Lipase

Auto digestion tissue damaged

Pancreatitis
 Neurologic Respiratory Circulatory Hematologic
•Anxious •Rapid shallow •Hypotension •Hypoalcemia
breathing
•Confusion •tachycardia •Hyperglycemia
•coma •Hyperlipasemia
•distress Increase WBC

GIT Endocrine Dermatologic

•Abdominal pain •Transient •Fever with cool
Hyperglycemia clammy skin
•Nausea/ •Pallor
•vomiting
•Turner’s signs •Jaundice
•Cullen’s signs
•steatorrhea
 Pancreatic enzymes — test for presence of the
enzymes—amylase and lipase—in the blood.
 Serum amylase —Marked increase (>3x the
normal) in the levels of amylase strongly suggest
the diagnosis of acute pancreatitis.
Levels of amylase in the blood rise within
6 to 12 hours after acute pancreatitis begins and
remain elevated for three to five days in
uncomplicated attacks.
 Serum lipase —Elevated serum lipase levels help
to confirm the pancreatic origin of elevated serum
amylase levels.
 Liver enzymes —helpful in determining the cause
 Imaging tests —provide information about the
structure of the pancreas, the ducts that drain the
pancreas and gallbladder, and the tissues
surrounding the pancreas.
 Chest X-ray — may reveal abnormalities such as
elevation of the diaphragm, collection of fluid in
the chest cavity, collapse of the base of the lungs,
and inflammation of the lungs which are indicative
of acute pancreatitis
 Abdominal ultrasound —identifies gallstones in
the gallbladder or in the ducts that drain the
gallbladder which may be the cause of acute
pancreatitis. However, this test cannot identify the
more serious abnormalities associated with
moderate and severe pancreatitis.

 CT scan —the most useful radiology test for

diagnosing acute pancreatitis that helps in
determining the extent of pancreatitis by
identifying enlargement or abnormal contours of
the pancreas.
 Magnetic Resonance Imaging Scan (MRI) —used
to assess the severity of disease, and identify
complications of pancreatitis such as fluid collections
and areas of necrosis or dead tissue.
 Endoscopic retrograde
cholangiopancreatography —detects presence
of gallstones or other problems with the bile or
pancreatic ducts.
 Fine needle aspiration — determines if the
damaged pancreatic tissue has become infected.
 Serum triglyceride levels —determines
blood levels of the fat-like triglycerides. In
patients with pancreatitis due to
hypertriglyceridemia, the triglyceride levels
are usually very high (>1000 mg/dL with
upper limit of normal being 150 mg/dL).
 Genetic tests —useful for diagnosing
hereditary forms of pancreatitis.
 NPO status and hydration with IV fluids
 meperidine hydrochloride (Demerol) for pain.
 Antacids to neutralize gastric secretions
 histamine H2 receptor antagonists to decrease
hydrochloric acid production and prevent activation
of pancreatic enzymes
 Anticholinergics to ↓ vagal stimulation, ↓GI
motility, and inhibit pancreatic enzyme secretion
 Avoid morphine sulfate or codeine sulfate because
they can cause spasm of the Sphincter of Oddi.
 Instruct client in the importance of avoiding
alcohol
 Instruct the client to notify physician if

acute abdominal pain, jaundice, clay-

colored stools, or dark urine develops
 Administer prescribed medications.
 Maintain NGT to decrease gastric distention

and suppress pancreatic supression, as

indicated.
 Pancreatic enzymes- aid in the digestion
and absorption of fat and protein
 Insulin or Oral Hypoglycemic medications-

to control diabetes mellitus, if present

 Supplemental preparations and vitamins

and minerals(vit. A and C and selenium)

to increase caloric intake.
 Instruct the client in the prescribed dietary
measures (fat and protein intake may be
limited).
 Instruct the client to avoid heavy meals.
 Instruct the client about the importance of

avoiding alcohol.
 Instruct the client to notify the physician if

increased steatorrhea occurs if abdominal

distention or cramping and skin breakdown
develops.