the fishshaped organ with a head body and tail the pancreas lies cradled between the loops of the small intestine kissing the inferior of the stomach an often unheard of entity it shot to fame when diabetes became rampant because insulin is manufactured in the pancreas the gland plays a dual role providing exocrine function secreting digestive pancreatic juice which it pours out through the pancreatic duct into the small gut to aid digestion and secreting insulin and glucagon hormones which regulate glucose metabolism into the blood streamwhile it makes its presence subtly felt in the impoverished diabetic it really announces itself with acute pancreatitis where the agonystricken patient needs to be necessarily hospitalised and given meticulous treatment in most cases while there are many postulates to the cause acute pancreatitis is usually viral if not unknown in aetiology gall stones or infected sludge blocking the pancreatic duct binge drinking alcohol or even acute gastritis are known to be the other causes acute unbearable continuous epigastric burning and searing pain radiating to the back and other quadrants of the abdomen impales the sufferer who writhes uncomfortably after no relief with conventional measures the patient presents to the hospital within 24 hours it is only a clinical index of suspicion wherein if the mind knows what the eye sees the diagnosis can be swiftly arrived at often time is lost with traditional therapy before the nickel drops and the required blood tests for amylase and lipase clinches the diagnosis besides other inflammation markers liver and kidney function tests are done the diagnostic ultrasound imaging of the organ confirms of course ct scans and other imaging may also be subsequently done the cardinal principle of medicine rest the injured organ is the prime modality of treatment a nasogastric tube is inserted and all gastric contents are aspirated and the patient is kept nbm nil by mouth since secreting juice to aid digestion when food is brought into the gut is its primary exocrine function by not allowing any solid or liquid content to go through into the alimentary tract the inflamed pancreas is allowed to heal care is taken to intravenously provide fluids nutrition and antibiotics when indicated even symptomatic treatment like painkillers antiacids etc are given by this alternative route while clinical assessment of the slow and mostly sure recovery is paramount the use of frequent blood tests and imaging modalities like ultrasound ct scans and mri are also invaluable when obstructing gall stones in the pancreatic duct are the culprit an mrcp specialised mri often helps to delineate the site all in all within a week the pancreas starts recovering the pain eases fatfree liquids are started and the patient discharged if there is no surgical cause rarely in the unfortunate with severe involvement a fatal outcome is seen since the pancreas secretes juice to enable the digestion of fats in the gut the patient is prescribed a fatfree diet to fortify the enzymatic action