Causes of Necrotizing Pancreatitis

Necrotizing Pancreatitis

is characterized by a sudden inflammation of the pancreas. It is essentially a more morbidity prone variant of the Acute Pancreatitis. About 185,000 cases of the acute form of the disease is recorded in the United States every year. Necrosis is found in about 20-30% of the cases. Necrosis increases the morbidity rates of the disease from 23% to 82%.
The word Necrosis means destruction of cells in the tissue or organ due to disease, trauma, injury and obstruction of blood flow to the concerned organ.

Causes of Necrotizing Pancreatitis

  • Alcohol Abuse

    : It is associated with heavy drinking. Alcohol can cause long term and irreversible damage to the pancreas.

  • Gallstones

    : Gall stones and alcohol abuse together account for 85% of the cases of this disease. Gallstones can travel via the bile duct and can get lodged in the Ampulla of Vater and can cause obstruction to the pancreatic juices flowing from the pancreas on to the duodenum. The reverse flow of the pancreatic digestive enzymes cause auto digestion or lysis (dissolution of the cells) of the pancreatic cells and consequent necrosis.

  • Abdominal Trauma

    : Any physical injury or trauma to the abdomen can bring about the condition.

  • Hyperlipidemia/Hypercalcemia

    : Presence of elevated levels of calcium and lipids( triglycerides)
    in the blood stream can cause the disease.

  • Drugs

    : Steroids, Sulfonamides, NSAIDs ( Non Steroidal Anti Inflammatory Drugs), diabetes medication etc can have a necrotizing effect on the cells of the pancreas.

  • ERCP

    : Trauma caused during the ERCP ( Endoscopic Retrograde Cholangio Pancreatography) procedure which involves the dual procedures of endoscopy and fluroscopy can cause it.

  • Diseases

    : Viral Diseases like mumps can cause the disease. Auto immune diseases can also cause it.

  • Pancreas Divisum

    : It is a congenital defect in which the two parts of the pancreas fail to join together to form a single pancreatic duct which is the main conduit in carrying the pancreatic enzymes.

Whenever due to the above causes the normal separation between the lysosomal and pancreatic enzymes is done away with and the pancreatic enzymes comes in contact with the lysosomal enzymes, it causes

necrotizing pancreatitis

. This is because the lysosomal enzymes are meant to degrade and destroy the macromolecules and other masses taken up by the cells through hydrolysis ( chemical break down of a compound due to reaction with water).

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