Complications of Pancreatitis
Complications of pancreatitis are usually due to acute pancreatitis and can be described as below.
- Massive hemorrhage may account for fatality initially.
- Collection of blood in the lesser sac though rare, is a dreaded complication. Sudden appearance of epigastria swelling should be suspected in this line. This will require surgery and the clot should be evacuated immediately.
- Development of pseudo-cyst occurs in about 12% of cases. Pseudo-cyst appears before the 2nd week of the disease.
- Pancreatic abscess formation is a fatal complication whose mortality rate is quite high approaching 100% if clostridia organisms are the cause of infection.
- Such abscess usually does not appear before the 3rd week. Gradually a swelling appears in the epigastria region or in the left flank.
- An abscess should be drained behind the peritoneum. It may cause obstruction of the common bile duct and even duodenum.
Pancreatitis Renal Failure
- Acute renal failure is also a fatal complication of this disease. Presence of progressive persistent reduction in urination, despite the correction of hypotension and dehydration, should be considered and treatment as acute renal insufficiency should be instituted.
- Haematemesis (vomiting of blood) and melena (anal bleeding) may sometimes complicate this condition. It is often a complication of alcohol pancreatitis and it carries bad prognosis.
- Acute psychosis is also a complication associated with acute pancreatitis among alcoholics.
- Pancreatic ascites (edema of abdomen due to collection of fluid) may be seen. This may also be due to cirrhosis following alcoholism.
Chronic Acute Pancreatitis
- Chronic pancreatitis may develop as an aftermath of acute pancreatitis due to damage to the pancreatic tissue.
- This is a quiet progressive fibrosis leading to pancreatic insufficiency, which gives rise to fat particles in stools (steatorrhea), nutritional deficiency and at times diabetes.
- Shock and cyanosis are the two distinct features of this condition, former is due to absorption of incompletely split products of protein and the latter to toxemia and anoxia caused by diminished excursion of the diaphragm resulting from inflamed pancreas.
- Diabetes mellitus may occur as a sequel of acute pancreatitis. The frequency of diabetes increases with the number of attacks.