Gallstone pancreatitis is inflammation of the pancreas that results from blockage of the pancreatic duct by a gallstone. This occurs at the level of the sphincter of Oddi, a round muscle located at the opening of the bile duct into the small intestine. If a stone from the gallbladder travels down the common bile duct and becomes stuck at the sphincter, it blocks outflow of all material from the liver and pancreas. This results in inflammation of the pancreas that can be quite severe. Gallstone pancreatitis can be a life-threatening disease and evaluation by a physician urgently is needed if someone with gallstones suddenly develops severe abdominal pain.
Symptoms include sudden onset of severe sharp abdominal pain mostly left upper abdomen or in the back and often associated with nausea and vomiting.
Diagnosis – Gall stone pancreatitis is usually diagnosed with blood works and imaging studies. Elevated amylase and lipase indicates pancreatic inflammation and elevated Liver function tests indicates obstructed bile flow from the liver. CT scan, MRCP or gall bladder ultrasound can be done to further assist in evaluating the cause of pancreatitis.
Pancreatitis is best treated initially by avoiding any intake of liquids and solids until the inflammation subsides. Intravenous delivery of fluids is usually all that is required if the inflammation is modest and symptoms resolve in a few days. Persistent pain or fevers suggest severe pancreatitis and ongoing inflammation. Intravenous delivery of nutrients should be started if oral intake cannot be resumed within approximately 5-7 days. Severe nausea and vomiting are treated initially by relieving the stomach of fluid by use of a nasogastric tube and with antinausea medications. Pain therapies may be administered by intravenous until oral treatments and food intake can resume. Sometimes it is important to remove a gallstone causing pancreatitis urgently, and other times it may be appropriate to wait 24-48 hours with regular assessments to assure the patient remains stable. Stones that cause gallstone pancreatitis may pass out of the duct without intervention or may require endoscopic or surgical removal. In cases of infected pancreatic tissue, or a condition called pancreatic necrosis (dead tissue) occurs, antibiotics may be used to control or prevent infection.
Do you need treatment for Gallstone Pancreatitis ? Call Gastroenterology Institute of Orlando, FL at 407-201-3686 to learn more about treatment!