Case Study: Pancreatitis/Hepatitis

Luke was a good friend of Rob Hall, who died in the Mt. Everest
disaster in 1996. Luke had anticipated climbing Everest with Rob
during his next expedition. He worked in an outdoor supply store
and had nearly acquired all of the equipment he’d need to climb
Everest, and had invested his money so that he could pay for the
trip. He was devastated by the tragedy. Luke has always had
problems with excessive drinking, but after Rob died he seemed to
really lose control.   His wife divorced him in 2000
since he spent more time drinking than sober. Shortly after she
left him, he woke up one night with severe abdominal pain. He was
sweating, felt nauseous and vomited. His abdomen was sore to touch
and felt swollen. His temperature was 101.5 degrees. This continued
for a couple of days before he went to the Immediate Care Center
and saw Dr. Bennett. Dr. Bennett requested lab tests, some of which
are listed below.

Height: 5’11

Weight: 170 lbs

Laboratory Tests:

Dr. Bennett told Luke that he had acute pancreatitis with early
signs of hepatitis. He explained to Luke that pancreatitis could be
deadly if it wasn’t taken care of immediately, since the digestive
enzymes may be secreted into the blood rather than through the
pancreatic duct. He also told Luke that if he stopped drinking, his
liver could clear up in a matter of weeks. He put Luke into the
hospital for several days, with an order of “NPO,” nothing by
mouth. He was fed intravenously while in the hospital. He was sent
home with a prescription for oral digestive enzymes and
instructions to eat a well balanced diet with no alcohol. Luke was
instructed to call back if the discomfort returned at all.

QUESTIONS:

1. The pancreas is an exocrine gland and endocrine gland. What
does that mean?   Describe the exocrine and endocrine
functions of the pancreas. What are the secretions involved with
each function?

2. Look at Luke’s lab reports. Which 3 tests are important in
diagnosing pancreatitis?

3. Why did Dr. Bennett put Luke on NPO orders in the hospital?
In your answer, use the words chyme, bicarbonate, and digestive
enzymes.