Recurrent Acute Pancreatitis

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Toni,

I wanted to add a little more about acute recurrent pancreatitis

Endoscopic minor papilla sphincterotomy is in about 70% effective treatment

for patients with recurrent pancreatitis. Following pancreatic sphincterotomy

there may be tissue swelling that could result in obstruction to pancreatic

outflow. Therefore, short-term pancreatic stenting is often indicated when

pancreatic sphincterotomy is performed to maintain patency (opening) of

pancreatic outflow. If pancreatitis reoccurs, then it is likely that the

original

pancreatitis was caused by stones or sludge vs SOD (Sphincter of Oddi

Dysfunction).

Another thing about recurrent bouts of pancreatitis is that it mainly occurs

in a gland which shows a normal morphology at the time of diagnosis, so that

it is generally believed that such a clinical entity is characterized by

repeated episodes of pancreatitis occurring in a normal pancreas. However, in a

number of cases, mild to moderate alterations of the pancreatic ductal system,

suggesting a chronic process, are seen either at the onset of the disease or

during the follow-up period. Therefore, the observed pancreatic lesions can

either suggest in these patients the presence of an underlying chronic

process which evolves over time with recurrent attacks of acute pancreatitis,

meaning you actually are having both reoccurring acute attacks as well as

chronic

pancreatitis at the same time. On the other hand, chronic pancreatitis can

be the consequence of multiple, single, self-limited acute inflammatory

episodes that induce persistent lesions within the gland with time. In all

cases,

chronic pancreatitis indicated by morphological abnormalities are likely to be

the consequence of a persistent or repeated obstructive mechanism.

There are cases where recurrent acute pancreatitis have resolved and not

progressed to chronic pancreatitis. So it is important to stay hopeful.

Karyn E. , RN

Executive Director, PAI

Indianapolis, Indiana