The pancreas is located deep in the abdomen and is a crucial role player in regulating blood sugar levels within the body. It is placed between the stomach and the spine and curled at the curvature of the duodenum. Due to its location, tumours developing in the pancreas are barely palpable. Symptoms of the tumour do not manifest till its advanced stage. It is only when the tumour interferes with the normal functioning of the pancreas or the other organs close to it such as the liver, gallbladder, stomach etc. that it is noticed.
There are several diseases of the pancreas:
Pancreatitis is inflammation of the pancreas. Pancreatic enzymes attack their own tissue before they are released into the small intestine a process known as autodigestion. Some of the most common causes of pancreatitis are alcohol abuse and gallstones besides other etiologies. There are two types of pancreatitis: Acute pancreatitis and chronic pancreatitis
Sudden inflammation of the pancreas develops in the acinar cells of the pancreas. The pain radiates to the back. Though it lasts for a short period of time, it can cause mild to severe discomfort. In severe cases of acute pancreatitis, tissue damage, bleeding, cyst formations and infections are noticed. Vital organs such as liver, kidneys and heart are also harmed. Severe acute pancreatitis is a medical emergency and most often requires intensive care treatment. The infective complications that may develop in this disease might necessitate surgical intervention. Infected pancreatic necrosis and pseudocysts can be tackled effectively with laparoscopic surgery.
In contrast, chronic pancreatitis is inflammation of the pancreas for a lengthy period of time. It is usually caused by alcohol abuse. However, in some patients, the cause may not be evident. There is a peculiar type of chronic pancreatitis affecting certain Indian ethnics, known as tropical calcific pancreatitis. This usually affects very young individuals leading to early diabetes and nutritional problems. Surgery to remove the stones and to drain the high-pressure pancreatic duct is indicated if the patient develops intractable pain. In some patients, pancreatic masses can develop and it is often regarded as a precancerous condition. Diarrhoea and upper abdominal pain is the most common symptom. At a more chronic level weight loss and malnutrition is also evident. As the disease progresses, the pancreas is destroyed giving room for the development of diabetes mellitus.
Cells of the pancreas are damaged and turn malignant or cancerous. It grows out of control thus developing into cancer. Different types of pancreatic cancer are adenocarcinomas (the most common), adenosquamous carcinoma and squamous cell carcinoma. As it grows insidiously, it does not cause symptoms at its initial stages. Pancreatic cancer can be treated with surgical resection if detected early.
A disorder of the sphincter at the region were bile duct and pancreatic duct opens into the small intestine is known as sphincter of Oddi dysfunction. The flow of pancreatic juice and from the pancreas to the small intestine is controlled by the sphincter of Oddi.
When there is an abnormality of the glands that produce sweat and mucus it is called cystic fibrosis. The disease is inherited and affects the digestive system, respiratory system, reproductive system and several other organs in the body.
Pancreatitis is a complex and difficult problem to relieve. We try to improve the patient's nutrition and relieve their pain before deciding upon any surgical intervention. We have vast experience in the surgical treatment of chronic pancreatitis.Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)
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