Case Study – Pancreatitis

At age 52, Arnold entered the hospital with complaints of a high fever, nausea, loss of appetite, and a dull, continual pain in the left side of the back. In addition, he had diarrhea of a particularly foul odor and yellow color. . He had also lost 18 pounds over the last month and a half. Please study the probing questions and the answers to this Pancreatitis Case Study thoroughly before answering our Discussion questions. Questions: Excessive exposure to alcohol can cause inflammation of certain digestive organs, such as the stomach. Inflammation of which organ(s) might be causing Arnold’s back pain? Based upon the location of this pain, would you guess that the organ in question is a retroperitoneal organ or an organ attached to the abdominal wall by a broad sheet of mesentery? Explain your answer. Answers: Chronic exposure to alcohol can cause pancreatitis – – i.e. inflammation of the pancreas. Since the pancreas is a retroperitoneal organ, the dull, throbbing pain associated with pancreatitis is often felt in the back. It is therefore likely that Arnold is suffering from alcohol-induced pancreatitis. The destruction of exocrine cells in the pancreas reduces this organ’s ability to secrete digestive enzymes and HCO3- ions into the duodenum during meals. Consequently, many of the nutrients in Arnold’s meals will never be completely digested, and therefore never absorbed into the bloodstream. Arnold will slowly lose weight due to this malabsorption syndrome. Based upon the function of the organ in question, what is causing the “steatorrhea” and weight loss? Answers: Since many of the nutrients Arnold ingests during a meal pass through the intestines unabsorbed, they osmotically draw water from the bloodstream into the intestinal lumen, causing an “osmotic diarrhea.” The high fat content of the stool gives it a foul odor and yellowish color – – a condition called steatorrhea. The inability of Arnold to absorb the nutrients of his meal will cause him to slowly lose weight. This malabsorption syndrome can now be treated with the ingestion of pancreatic enzymes with each meal. Discussion Questions Case Study 2b: 1. What is Pancreatitis? 2. What is Steatorrhea? 3. What are some of the pancreatic enzymes that could be used to treat Arnold? 4.What did you learn from this case study on how to approach a gastrointestinal complaints by a patient?