lies between the stomach & duodenum

The pancreas is a dual-function gland, having features of both endocrine

and exocrine glands.
Endocrine gland produces several hormones such as insulin,
glucagon,somastostatin & pancreatic polypeptide
The pancreas also functions as an exocrine gland that assists the
digestive system. It secretes pancreatic fluid that contains digestive
enzymes that pass to the small intestine. These enzymes help to further
break down the carbohydrates, proteins and lipids (fats) in the chyme.
Control of the exocrine function of the pancreas is via the hormones
gastrin, cholecystokinin and secretin, which are hormones secreted by
cells in the stomach and duodenum, in response to distension and/or
food and which cause secretion of pancreatic juices. Gastrin is a peptide

The risk of acute pancreatitis in patients with at least one gallstone <5
mm in diameter is fourfold greater than that in patients with larger
stones.

Hypertriglyceridemia is the cause of acute pancreatitis in 1.33.8% of

cases; serum triglyceride levels are usually >11.3 mmol/L (>1000
mg/dL)

In 2nd phase it will result into intrapancreatic inflammatory rxn.

3rd phase- Activated proteolytic enzymes, especially trypsin, not only
digest pancreatic and peripancreatic tissues but also activate other
enzymes such as elastase and phospholipase A2. The active enzymes
and cytokines then digest cellular membranes and cause proteolysis,
edema, interstitial hemorrhage, vascular damage, coagulation necrosis,
fat necrosis, and parenchymal cell necrosis. The systemic inflammatory
response syndrome (SIRS) and acute respiratory distress syndrome
(ARDS) as well as multiorgan failure may occur as a result of this
cascade of local as well as distant effects.

-nausea,vomiting & abdl distention is due to gatric & intestinal

hypomotility
Shock is not unusual and may result from (1) hypovolemia secondary to
exudation of blood and plasma proteins into the retroperitoneal space
and a "retroperitoneal burn" due to activated proteolytic enzymes; (2)
increased formation and release of kinin peptides, which cause
vasodilation and increased vascular permeability; and (3) systemic
effects of proteolytic and lipolytic enzymes released into the circulation.
Jaundice occurs infrequently. due to edema of the head of the pancreas
with compression of the intrapancreatic portion of the common bile duct.

The latter two findings, which are uncommon, indicate the presence of a
severe necrotizing pancreatitis.

Early predictors of severity at 48 hours included 3 Ranson's signs and

APACHE II score 8

hemoconcentration with hematocrit values >44% because of loss of

plasma into the retroperitoneal space and peritoneal cavity.
A threefold elevated serum lipase value is usually diagnostic of acute
pancreatitis

Sonography is useful in acute pancreatitis to evaluate the gallbladder if

gallstone disease is suspected.