Acute Pancreatitis Case Studies

Lower back pain is reported to be the most common symptom experienced by chiropractic patients (1). Lower back pain can often result from trauma, degenerative changes or postural stress (1). However, patients with uncommon causes of back pain also present to chiropractic offices. One such example is acute pancreatitis (1). Acute Pancreatitis (AP) is a potentially life threatening gastrointestinal disorder characterised by the sudden inflammation and haemorrhaging of the pancreas resulting from tissue destruction by its own digestive enzymes, with the potential to elicit multiple organ failure (1,2,3). AP is one of the most frequent gastrointestinal causes of hospitalisation in the US (4) with over 50% of AP patients experiencing back pain that radiates from the epigastric region comparable to that of mechanical spine pain (1,4,5). The back pain typically refers to the lower thoracic vertebrae, eventually radiating towards the sub scapular regions, the shoulder and iliac fossa, then the whole abdomen (1,5,6). Pain is often exacerbated by vigorous, movement, coughing, deep breathing or excessive alcohol consumption (6). Over 80% of

As a result, the pancreatic juices become thick and viscous potentially creating a plug that can cause a biliary duct blockage (2,14, 15). Duct obstruction from pancreatic juice and its content increases pressure, leading to distension of the duct also (13, 14, 15). At a cellular level, membrane trafficking becomes chaotic, potentially leading to Trypsinogen activation into trypsin, initiating the cascade of digestive enzyme activation and autodigestion of the pancreas, causing AP (13,14, 15). Alcohol abuse further prompts acinar cells to release inflammatory cytokines, attracting a strong immune reaction causing pancreatic tissue destruction (13,14,