Enlarged Pancreas: Causes, Symptoms, and Treatments

An enlarged pancreas can occur for many reasons. The pancreas is a gland that sits behind your stomach in the upper abdomen and helps with digestion. It produces enzymes that are secreted into the small intestine, digesting protein, fat, and carbohydrates. The pancreas also produces insulin to help regulate blood sugar (glucose), the body's main source of energy.

An enlarged pancreas may mean nothing. You may simply have a pancreas that is larger than normal. Or, it can be because of an anatomic abnormality. But other causes of an enlarged pancreas may include the following:

• Pancreatitis occurs when digestive enzymes become active inside the pancreas, attacking and damaging its tissues. This can cause an enlarged pancreas.
• Acute pancreatitis is inflammation that occurs suddenly in the pancreas. It can be very serious, even life-threatening. But it usually goes away within a few days of treatment. Gallstones and alcohol are common causes of acute pancreatitis. Other causes include high levels of fats or calciumin in the blood, certain drugs, certain medical procedures, and some infections.
• Chronic pancreatitis is inflammation that gets worse over time and leads to permanent damage in the pancreas. Heavy alcohol use is the most common cause. Other causes include heredity, cystic fibrosis, high levels of calcium or fats in the blood, certain medications, and some autoimmune conditions.
• Pancreatic pseudocyst is an accumulation of fluid and tissue debris in the pancreas, which can occur after a case of pancreatitis.
• Cystadenoma is a tumor that is usually benign.
• Abscess is a pus-filled cavity, usually caused by a bacterial infection. A pancreatic pseudocyst that becomes infected can become an abscess.
• Pancreatic cancer is an abnormal growth of cells in the pancreas that can spread to other parts of the body.

Pain in the upper abdomen is a common symptom. Pain may spread to the back and feel worse when you're eating and drinking, such as in cases of pancreatitis. See a doctor right away if you have these symptoms.

Other causes of an enlarged pancreas may produce few or no symptoms at all. Pancreatic cancer is considered one of the deadliest cancers. It is difficult to catch at an early stage because of its usual lack of symptoms.

The doctor will ask questions and do a thorough physical exam. Your doctor may also order blood, urine, or stool tests and a scan to diagnose and confirm the cause of an enlarged pancreas. For example, you may have an X-ray, ultrasound, CT scan (computerized tomography scan), ERCP (endoscopic retrograde cholangiopancreatography), or MRCP (magnetic resonance cholangiopancreatography).

Other symptoms that may accompany an enlarged pancreas include:

• Nausea and vomiting
• Diarrhea or oily stools
• Weight loss
• Fever
• Rapid pulse
• Jaundice

Treatment depends upon the cause of the enlarged pancreas.

Treatment for acute pancreatitis includes a hospital stay with:

• Intravenous (IV) fluids
• Antibiotics if necessary
• Medication for pain

Treatment may also involve removing gallstones or the gallbladder. The doctor will likely also advise you to stop smoking, drinking alcoholic beverages, and eating fatty meals.

Treatment for chronic pancreatitis also may include hospitalization as well as nerve blocks or even surgery. Treatment and self-care are similar to that for acute pancreatitis. Once you resume a normal diet, you may need pancreatic enzymes to aid digestion. When advanced, chronic pancreatitis can also lead to diabetes which requires insulin.

Treatment for various pancreatic conditions may include a specialized technique using an endoscope. It is called therapeutic endoscopic retrograde cholangiopancreatography (ERCP). A doctor can use this technique to:

• Enlarge a duct opening
• Remove pancreatic or bile duct stones
• Place a stent to keep a pancreatic or bile duct open
• Dilate or stretch a narrowed pancreatic or bile duct
• Drain pseudocysts

In some cases, surgery or other procedures are needed.

Treatment for pancreatic cancer may include surgery, radiation, or chemotherapy.