The patient is admitted with severe abdominal pain due to pancreatitis. The patient asks the nurse, "What causes this? Why does it hurt so much?" The nurse should Answer:
a. "Pancreatitis is extremely rare and no one knows why it causes pain."
b. "Pancreatitis is caused by diabetes; you should be checked."
c. "Injury to certain cells in the pancreas causes it to digest (eat) itself, causing pain."
d. "The pain is localized to the pancreas. Fortunately, it will not affect anything else."
C
The most common theory regarding the development of pancreatitis is that an injury or disruption of pancreatic acinar cells allows leakage of the pancreatic enzymes into pancreatic tissue. The leaked enzymes (trypsin, chymotrypsin, and elastase) become activated in the tissue and start the process of autodigestion. Pancreatitis is one of the most common pancreatic diseases; it is not caused by diabetes. The activated enzymes break down tissue and cell membranes, causing edema, vascular damage, hemorrhage, necrosis, and fibrosis. These now toxic enzymes and inflammatory mediators are released into the bloodstream and cause injury to vessel and organ systems, such as the hepatic and renal systems.
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