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Forum Name: Gastroenterology Topics

Question: Distal Pancreatectomy with recurrent Pancreatitis


 rn4heads - Tue Aug 26, 2008 12:39 pm

In 4/07 I was admitted to the hospital and diagnosed with Pancreatitis. I had no history of alcohol abuse or gallbladder disease. A CT and MRCP showed a cystic mass. A EGD/EUS was performed with fine needle aspiration. The GI doctor was concerned that it was an IPMN. The pathology eventually revealed a pseudocyst that needed to be removed. I had a distal pancreatectomy in May. He removed about 70% of my pancreas and my GB. Since then, I have been hospitalized 5 times with pancreatitis. Each hospitalization lasts about 5-7 days with massive IV fluids and being NPO. I have had many more CT's and MRI's which show a resolving psuedocyst adjacent to the cut margin of the pancreas. I have also had several more EGD's and ERCP's because the doctors are unclear of the etiology of the recurring pancreatitis. They have looked for autoimmune pancreatitis and anatomic abnormalities such as pancreatic divisum. I have been put on Creon in the hopes that it will help the remainder of the pancreas "rest". This has made the recurrence of pancreatitis less often. I have altered my diet to low fat and of course low sugar due to the new diabetes. My question is: Am I going to have these recurrent bouts of pancreatitis the rest of my life? Is there anything else you could suggest? I almost wish the surgeon had removed the whole pancreas.
 Parks P, RN - Sun Dec 28, 2008 5:07 pm

User avatar Hello, as I'm sure you know the two most typical causes of pancreatitis are stones and alcoholism. In your case both have been ruled out. Most chronic pancreatitis has no clear cause.(idiopathic) The symptoms of chronic pancreatitis are the same as acute and they fall into two patterns. One pattern the person has mid-abdominal pain varying in intensity. In this pattern it is more likely from a cyst or mass. The second pattern the person has occasional flare ups with symptoms of mild to moderate pancreatitis the pain may last for hours or days. Eventually the pain may stop due to loss of cells that produce digestive enzymes. If you continue to have pain without complications, the doctor may recommend injecting a local anesthetic (i.e Lidocaine) and corticosteroids like Depo-Medrol or Prednisone into the nerves of the pancreas thus blocking the pain impulse to the brain. Some reasons a person may develop pancreatitis other than discussed above would be drug induced, this would include Amiodarone used for cardiac arrhythmia , Lisinopril ACE for high B.P. very rare but some oral diabetic drugs. Other reasons include hereditary predisposition and hyperparathyroidism .


Good Luck, Paul

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