Understanding acute pancreatitis and pancreatic necrosis
Received: 30-Jan-2023, Manuscript No. AJDM-23- 93129 ; Editor assigned: 01-Feb-2023, Pre QC No. AJDM-23- 93129 (PQ); Reviewed: 15-Feb-2023, QC No. AJDM-23- 93129 (PQ); Revised: 20-Feb-2023, Manuscript No. AJDM-23- 93129 (R); Published: 27-Feb-2023
The pancreas is a highly sensitive oblong gland located just behind the stomach, especially in the epigastric and left hypochondrium regions of the abdomen. Diseases of the pancreas are notoriously difficult to study and understand due to their location.1 Detailed examination and diagnosis of pancreatic disease often requires highly specialized equipment and expertise, which are not always readily available, especially in developing countries. Routine and inexpensive imaging modalities such as trans-abdominal ultrasonography are not very accurate in diagnosing pancreatic disorders. The pancreas is often obscured by abdominal gas and other organs and cannot be fully visualized, leading to misdiagnosis. Furthermore, symptoms of pancreatic disease are often multifactorial, ambiguous and non-specific, leading to poor diagnosis as only 9.7% of all pancreatic cancers are detected at an early stage.
More effective diagnostic techniques are costly, invasive, and require access to pancreatic disease specialists with deep skills and knowledge, further complicating diagnosis.2 The pancreas is a major organ that performs endocrine functions such as the secretion of insulin and glucagon (key hormones involved in regulating glucose homeostasis) and exocrine functions such as the secretion of digestive enzymes such as amylase and lipase into the duodenum. By incorporating innovative technologies in the fields of genetics, molecular biology, and new in vitro and in vivo models of pancreatic disease, the pancreas now plays a vital role in regulating and maintaining normal physiological function recognized as an organ.3 These advances have advanced our understanding of pancreatic physiology and pathophysiology, improved our understanding of previously enigmatic diseases, and opened new avenues for disease treatment and prevention.
Increasing the number of transplanted islet cells dramatically improves patient outcomes and contributes to insulin independence. This is because multiple islet cell injections are often required to achieve significant clinical benefit. Moreover, great progress has been made in bio-printing an artificial pancreas from biodegradable biopolymers embedded with bioactive factors and cells to promote growth and development. Pancreatitis is a serious condition characterized by inflammation of the pancreas. The disease is classified as acute or chronic pancreatitis based on clinical presentation and pathophysiology.
Acute Pancreatitis (AP) is an acute inflammatory disease of the pancreas with various clinical and morphological manifestations. Patients with AP present with sudden, severe epigastric pain that often radiates to the back, abdominal pain that worsens after eating, abdominal pain, nausea, vomiting, fever, and rapid pulse episodes.4 Mild AP is characterized by the absence of local or systemic complications, and severe AP is characterized by persistent failure of one or more organs, usually with infected pancreatic necrosis.
Early changes in the pancreas are often difficult to detect using conventional imaging techniques, and even the most advanced equipment currently available cannot detect these early changes uses endoscopic ultrasound technology. In this method, a thin, flexible ultrasound probe is inserted into the mouth and guided into the stomach to provide a better vantage point for viewing the pancreas. This facilitates examination of the pancreas and biopsy using a fine needle. Since pancreatitis is a risk factor for malignant transformation leading to pancreatic cancer, BBR’s ability to prevent and reverse pancreatitis may have promising implications for cancer prevention.
- Bollen TL. Acute pancreatitis: International classification and nomenclature. Clin Radiol; 2016:71:2:121-3.
- Iovanna JL. Redifferentiation and apoptosis of pancreatic cells during acute pancreatitis. Int J Pancreatol; 1996:20:2:77-84.
- Barthlen W. Surgery in congenital hyperinsulinism-tips and tricks not only for surgeons. A practical guide. Semin Pediatr Surg; 2011:20:1:56-9.
- Beger HG. Surgical management of necrotizing pancreatitis. Surg Clin North Am; 1989:69:3:529-49.