What is acute hemorrhagic pancreatitis?

The mysterious disorder that caused the death of popular young actor Rico Yan last week remains a puzzle to medicine as no specific cause is yet known to trigger the affliction.

According to gastroenterologist Dr. Higino Mappala, assistant medical center chief and a specialist-consultant on internal medicine of the Dr. Jose R. Reyes Memorial Medical Center, acute hemorrhagic pancreatitis (AHP) has several known risk factors such as alcohol and drug intake, gallstones, viral infections, obesity, trauma, intake of fatty foods and metabolic disorders.

Mappala defined AHP as a severe form of inflammation of the pancreas, a digestive organ located in the posterior of the stomach.

Acute pancreatitis may be caused by several factors, Mappala explained, but the specific mechanism by which these factors trigger pancreatitic inflammation has not been identified.

Mappala cited the case of alcoholic drinkers wherein an occasional and even a first-time drinker of alcohol may suffer from acute pancreatitis but it may not happen to an alcoholic.

He also stressed that AHP and dying due to a bad dream or nightmare, or what is termed colloquially in the Philippines as bangungot , are two different things. Medicine, he said, does not recognize bangungot as an official cause of death.

It was learned that AHP is characterized by mild to severe abdominal pain. The pain is steady, localized at the epigastrium, and often radiates to the back, more intense when the patient is in supine position. The abdominal pain is often relieved by sitting with the trunk flexed and knees drawn up.

One can only ascertain that one is suffering from AHP only after numerous tests.

Mappala clarified that AHP may strike whether or not a person is sleeping.

In cases such as that of Yan who was reported to have been struck by AHP while sleeping, Mappala gave this advise: "When you see a person moaning in his sleep and doubling up in pain, wake him up gently and immediately rush him to the hospital."

He said, however, that cases of AHP are hard to revive particularly when the patient is brought to the hospital late or when the attack is really severe.

On the matter of Yan being a heavy snorer as reported by people close to him, Mappala said that a heavy snorer has a bigger chance of suffering from apnea or a situation akin to that of a breakdown in respiration while sleeping.

Mappala said, however, that an autopsy had already declared AHP as the cause of Rico Yan’s death.