Patient overcomes rare acute necrotizing pancreatitis

"I pulled on to the shoulder of the road, buckled over and began throwing up," the 51 year-old remembers. "Ironically, I was going to care for my daughter and now I was the one getting ill. I felt like an 800 pound elephant was sitting on my stomach."

Mr. Jacob called an ambulance from a gas station and was taken to a local community hospital. "I thought I was going to die," he said. "My liver was shutting down, they couldn't get an IV in me and I was getting weaker and weaker."

The former construction company executive turned pastor was transferred to Loyola University Medical Center where he had been treated for pancreatic cancer eight years earlier.

"This was a very complicated case; we pulled in a multidisciplinary team of specialists immediately and through a series of tests diagnosed acute necrotizing pancreatitis," said Bipan Chand, MD, co-director of Loyola Medicine's digestive health program. "Only 30 percent of Mr. Jacobs' pancreas was functioning, his body was breaking down and his condition was dire."

Pancreatitis is a painful condition most commonly caused by gallstones developing and becoming lodged in the bile duct. The pancreas is an organ in the abdomen about 6 inches long located behind the stomach. The pancreas has two functions: • It makes enzymes, which help digest proteins, fats, and carbohydrates before they can be absorbed in the intestine. • It makes hormones (chemicals made from glands), the most important of which is insulin, which control how the body uses and stores sugar (glucose), its main source of energy.

"Pancreatitis is relatively common but severe necrotizing pancreatitis is very rare. And Larry had a very, very complex case. There was a very high chance of multi-organ failure and a high risk of him not surviving," said Neil Gupta, MD, co-director of Loyola Medicine's digestive health program. "In Larry's condition, his pancreas was inflamed and the tissue eats itself and dies. The dead tissue in the body becomes a forum for bacterial infection that can easily be deadly."

A pseudocyst, or collection of fluid, developed in Mr. Jacob's stomach, causing life-threatening complications including infection. His gall bladder was also infected and needed to be removed but the fluids had to be cleared first.

In an orchestrated series of six procedures conducted over a span of many weeks, the Loyola team systematically removed the potentially infectious liquid.

"We used a minimally invasive approach inserting flexible tubes in his mouth that went down to his stomach," said Dr. Gupta. "We drilled holes in his pancreas and literally cleaned Larry's organs from the inside out to minimize his risk for further injury."

Mr. Jacob was throwing up 10 to 15 times per day and the 6-ft. former triathlete dropped from 230 to 160 pounds.

"I was told that it looked like World War III inside my body," said Mr. Jacob. "But after my gall bladder was finally removed, I felt like a million dollars. I began to gain back my strength and my weight."

Mr. Jacob credits the unique bond he formed with his Loyola caretakers as being key to his recovery. "I thought I was going to die many times because the recovery process took so long and was so complicated," he said. "But my doctors and nurses always kept me informed and encouraged me. I prayed daily with the pastoral care team. I really appreciated that Loyola didn't just care for me but also for my family. Because I was so ill, my family was really hurting, too."

After more than five months at Loyola, Mr. Jacob went home a changed man. "With the Lord's guidance, I left the business world to serve others after my bout with cancer and after this second life-threatening experience, I am more committed than ever to helping people and celebrating life," said the pastor at a Barrington church. "I honestly thought I was going to die during my illness. I thank God, and Loyola, that I am still alive."