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  • Acute pancreatitis is inflammation of the pancreas caused by the release of activated pancreatic enzymes. Common triggers are biliary tract disease and chronic heavy alcohol intake.  Diagnosis is based on clinical presentation and serum amylase and lipase levels. Treatment is supportive, with IV fluids, analgesics, and fasting.
  • Chronic pancreatitis is persistent inflammation of the pancreas that results in permanent structural damage with fibrosis and ductal strictures, followed by a decline in exocrine and endocrine function. It can occur as the result of chronic alcohol abuse but may be idiopathic. Initial symptoms are recurrent attacks of pain. Later in the disease, some patients develop malabsorption and glucose intolerance. Diagnosis is usually made by imaging studies such as ERCP, endoscopic ultrasonography, or secretin pancreatic function testing. Treatment is supportive, with dietary modification, analgesics, and enzyme supplements. In some cases, surgical treatment is helpful.

Pancreatitis can affect both the exocrine and endocrine functions of the pancreas. Pancreatic acinar cells secrete bicarbonate and digestive enzymes into ducts that connect the pancreas to the duodenum at the ampulla of Vater (exocrine function). Pancreatic β-cells secrete insulin directly into the bloodstream (endocrine function).

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