Pancreatitis is an inflammation of the pancreas, an organ that secretes digestive enzymes through the pancreatic duct. Digestive enzymes mix with bile from the gallbladder to digest food. Acute pancreatitis is most often caused by gallstones that lodge in the common bile duct, the duct that connects the liver, gallbladder and pancreas to the small intestine. Blockage in the common bile duct can cause liver enzymes, including alkaline phosphatase, to rise and can also lead to pancreatitis.
Definition
Alkaline phosphatase is an enzyme produced mainly in the liver and bone. Alkaline phosphatase levels in the blood rise when tissues primarily in the liver or bone are damaged, releasing the enzyme into the bloodstream. Inflammation in the liver develops if the common bile duct becomes blocked by gallstones and bile backs up into the liver, causing damage.
Symptoms
Rising alkaline phosphatase levels require investigation to determine the cause. Symptoms of pancreatitis include pain in the upper right quadrant of the abdomen that may also extend to your back. Nausea and vomiting often occur; your abdomen may be swollen and tender to touch. Fever and a rapid pulse may also occur. People with pancreatitis look and feel quite ill.
Diagnosis
High alkaline phosphatase levels are diagnosed by blood tests. Elevated alkaline phosphatase levels can occur in a number of diseases, not just pancreatitis. In pancreatitis, liver enzymes, including alkaline phosphatase, may rise rapidly when the pain first begins and then fall over the next one to two days, according to Christopher E. Forsmark in "Pancreatitis and Its Complications." Levels of amylase and lipase, two enzymes produced in the pancreas, will also be elevated. Because the pancreas lies deep within the abdominal cavity, diagnosing pancreatitis can be difficult, according to the National Institute of Diabetes and Digestive and Kidney Disorders. Abdominal ultrasound, a CT scan or an MRI can be used to diagnose pancreatitis, along with clinical symptoms and lab work.
Complications
If a gallstone is blocking the common bile duct, removal of the gallbladder and any stones will remove the blockage and allow inflammation of the pancreas to heal. Acute pancreatitis could cause acute kidney failure, which could lead to a need for dialysis or a kidney transplant. Pancreatitis can also lead to pseudocysts -- tissue and debris buildup in the pancreas that can push toxins into the bloodstream, heart, lungs or other organs.
References
- drkaslow.com; Alkaline Phosphatase; Jeremy Kaslow, M.D.
- "Pancreatitis and Its Complications;" Christopher E. Forsmark ; Humana Press; October 2004
- University of Maryland Medical Center; Gallstones; Harvey Simon, M.D.; June 2009
- Cleveland Clinic: Bile Duct Exploration
- National Institute of Diabetes and Digestive and Kidney Disorders; Pancreatitis; July 2008
