Although most people with acute pancreatitis recover without experiencing further problems, severe cases can have serious complications.
Pseudocysts are sacs of fluid that can develop on the surface of the pancreas. They're a common complication of acute pancreatitis, thought to affect around 1 in 20 people with the condition.
Pseudocysts usually develop four weeks after the symptoms of acute pancreatitis start. In many cases, they don't cause any symptoms and are only detected during a computerised tomography (CT) scan.
However, in some people, pseudocysts can cause bloating, indigestion and a dull abdominal (tummy) pain.
If the pseudocysts are small and not causing any symptoms, there may be no need for further treatment, as they usually go away on their own.
Treatment is usually recommended if you're experiencing symptoms or if the pseudocysts are large. Larger pseudocysts are at risk of bursting, which could cause internal bleeding or trigger an infection.
Pseudocysts can be treated by draining the fluid out of the cyst by inserting a needle into it through your skin. This can also be done by carrying out an endoscopy, where a thin, flexible tube called an endoscope is passed down your throat, and tiny tools are used to drain away the fluid.
Infected pancreatic necrosis
In around one in three severe cases of acute pancreatitis, a serious complication called infected pancreatic necrosis occurs.
In infected pancreatic necrosis, high levels of inflammation cause an interruption to the blood supply of your pancreas. Without a consistent supply of blood, some of the tissue of your pancreas will die. Necrosis is the medical term for the death of tissue.
The dead tissue is extremely vulnerable to infection from bacteria. Once an infection has occurred, it can quickly spread into the blood (blood poisoning) and cause multiple organ failure. If left untreated, infected pancreatic necrosis is almost always fatal.
Infected pancreatic necrosis usually develops two to six weeks after the symptoms of acute pancreatitis starts. Symptoms include increased abdominal pain and a high temperature. The infection is treated with injections of antibiotics, and the dead tissue needs to be removed to prevent the infection returning.
In some cases, it may be possible to drain away the dead tissue using a thin tube called a catheter, which is placed through the skin.
Alternatively, laparoscopic surgery (keyhole surgery) can be used. A small cut is made in your back and an endoscope is inserted to wash away any dead tissue. If laparoscopic surgery isn't possible, a cut can be made in your abdomen to allow the dead tissue to be removed.
Infected pancreatic necrosis is a very serious complication. Even with the highest standards of medical care, the risk of dying from organ failure is estimated to be around one in five.
Systemic inflammatory response syndrome (SIRS)
Another common complication of severe acute pancreatitis is systemic inflammatory response syndrome (SIRS). SIRS develops in an estimated 1 in 10 severe cases of acute pancreatitis.
In SIRS, the inflammation affecting the pancreas spreads throughout the body, which can cause one or more organs to fail. It usually develops during the first week after the symptoms start, with most cases developing on the same day.
Symptoms of SIRS include:
- a rise in body temperature to above 38C (100.4F) or a fall in body temperature to below 36C (96.8F)
- a rapid heartbeat of more than 90 beats a minute
- an unusually fast breathing rate (more than 20 breaths a minute)
There's currently no cure for SIRS, so treatment involves trying to support the body's functions until the inflammation has passed. The outcome depends on how many organs fail. The higher the number of organs affected, the greater the risk of death.
If you have repeated episodes of acute pancreatitis, the damage to your pancreas may lead to chronic pancreatitis.
Chronic pancreatitis is a long-term condition that can have a serious impact on your quality of life.