The pancreas is a complex gland located in the upper middle part of the abdominal cavity. It has both endocrine and exocrine roles, as explained under Pancreas Function, which affects the digestion, absorption, metabolism and storage of nutrients.
Various diseases that may affect the pancreas produces a range of symptoms, both local and generalized. Some of the symptoms of pancreas problems include :
- Hyper- or hypoglycemia – abnormally high or low blood glucose levels
- Steatorrhea – fat in the stool
- Unintentional weight loss
- Loss of appetite
- Abdominal pain (with/without back pain)
- Nausea and/or vomiting
- Malaise and weakness
The clinical presentation varies according to each pancreatic disease and depends on the severity of the condition. Problems with the pancreas may progress and lead to a number of complications affecting other organs, especially the gallbladder, liver and bile ducts, and other systems, particularly those involved with digestion and metabolism.
Causes of Pancreas Problems
Acute and Chronic Pancreatitis
Pancreatitis is the medical term for inflammation of the pancreas. It may lead to necrosis of the pancreatic tissue, abscess formation or pseudocysts. Chronic pancreatitis may be associated with pancreatic carcinoma.
Acute pancreatitis occurs when the pancreatic enzymes are prematurely activated while in the gland. This begins to digest the pancreatic tissue leading to damage that is often reversible. Common causes of acute pancreatitis includes gallstones, alcohol abuse, following procedures like and ERCP and other unknown factors.
Chronic pancreatitis is an inflammatory condition of the pancreas where persistent or recurrent inflammation leads to destruction of the pancreas tissue. Initially the exocrine tissue is irreversibly damaged but as the condition progreses, the endocrine parenchyma is also destroyed. Common causes include long standing cases of the same causative factors for acute pancreatitis. Alcohol misuse is by far the most common cause while malnutrition, infections, congenital abnormalities, autoimmune factors and diseases of other organs/systems (secondary) are also responsible.
Most cases are due to ductal adenocarcinoma, which as the name suggests, starts in the pancreatic ducts. Other carcinomas of the pancreas include acinar cell carcinoma and pancreatoblastoma. Pancreatic carcinoma has one of the highest mortality rates of any cancer and is among the more common type of cancer. It is more commonly seen in men and is associated with age, smoking and chronic pancreatitis. Hereditary factors and genetic alterations may also play a role.
Pancreatic cysts are enclosed sacs within the pancreatic tissue.
Pseudocysts are the more common type of pancreatic cysts. These non-neoplastic cysts are filled with necrotic material and is often caused by pancreatitis or trauma to the abdomen.
Congenital cysts are another type of non-neoplastic cyst filled with a clear serious fluid. It is often associated with polycystic diseases and cysts may be found in many other organs simultaneously, including the liver and kidney.
Neoplastic cysts are usually benign, but some like a mucinous cystic neoplasms are malignant. Genetic factors may also be responsible for cyst formation.
Congenital Pancreatic Abnormalities
These abnormalities are present from birth a result of disruptions in fetal development.
- Pancreas divisum
- Annular pancreas
- Ectopic pancreas
- Agenesis (rare)