Ashcroft in intensive care for gallstone pancreatitis

WASHINGTON -- Attorney General John Ashcroft was in a hospital intensive care unit Friday after suffering a severe case of gallstone pancreatitis, a serious and painful abdominal illness.

Ashcroft, a 61-year-old former Missouri senator and governor, was being treated with antibiotics. The ailment often clears up after a week or so of treatment but sometimes requires surgery. In extreme cases, it can cause death.

Doctors at George Washington University Hospital said they needed more time to evaluate Ashcroft and make a prognosis. It's possible Ashcroft could remain hospitalized for a month or more, medical experts said.

President Bush spoke briefly with Ashcroft by telephone Friday afternoon, White House press secretary Scott McClellan said.

"Our thoughts are with the attorney general," McClellan said in Crawford, Texas. "We wish him a speedy recovery."

Under Justice Department rules, Deputy Attorney General James Comey is authorized to exercise "all power and authority" of the attorney general. No transfer of power is necessary.

Ashcroft initially thought his sudden sickness was a stomach flu. But he began feeling so ill Thursday afternoon that he canceled an appearance at a news conference where he was to announce terrorism convictions.

After returning to his Capitol Hill home, his condition worsened and he was examined by Dr. Daniel Parks, the White House physician, said Justice Department spokesman Mark Corallo. Parks advised Ashcroft to go to an emergency room, and the attorney general was taken to the hospital Thursday evening.

"After a full medical work-up in the emergency room, it was determined that he was suffering from a severe case of gallstone pancreatitis," Corallo said.

Pancreatitis is an inflammation of the pancreas, a gland that secretes digestive enzymes and insulin. The two main causes are alcohol abuse and, as in Ashcroft's case, a gallstone that blocks the passage from the pancreas to the beginning of the small intestine. It also may be caused by infection, injury or certain medications.

The illness also often occurs when a gallstone becomes lodged in the passage that leads from the pancreas to the small intestine. Symptoms include sudden, severe abdominal pain, loss of appetite, nausea, vomiting and fever.

About 20 percent of the 80,000 cases of acute pancreatitis each year are classified as severe, according to the National Institutes of Health.

Dr. John Baillie, a gastroenterologist and professor of medicine at Duke University Medical Center, said people with severe pancreatitis often stay in the hospital for a month or longer. He said there is a 10 percent to 20 percent risk of death, but those tend to occur among older people who have underlying medical conditions such as kidney disease or poorly controlled diabetes.

Baillie explained that pancreatitis is "like a hand grenade going off, an explosion in the abdomen" that essentially shuts down the digestive system and causes a sharp internal buildup in fluids.

Treatment involves fasting, to allow the pancreas to rest by reducing its secretions, as well as antibiotics and painkillers. Pancreatitis caused by a gallstone usually eases when the gallstone passes, but sometimes surgery is necessary.

Much depends on whether the inflammation is severe enough to cause serious damage to the pancreas, which can trigger low blood pressure and damage other organs. Half of all severe pancreatitis patients require surgery later to remove dead tissue in the pancreas.

Ashcroft is something of a fitness buff. He enjoys hiking, skiing, playing basketball and clearing brush on property he owns in western Virginia. He usually takes five flights of stairs rather than the elevator to and from his office suite in the Justice Department.

He also is highly religious. At the Springfield, Mo., headquarters of his denomination, the Assemblies of God, the Rev. Thomas E. Trask used the intercom system to lead some 1,100 employees in a prayer for Ashcroft.

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Associated Press Medical Writer Lauran Neergaard contributed to this report.

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On the Net:

National Institutes of Health: http://www.nih.gov

George Washington University Hospital: http://gwhospital.com

Justice Department: http://www.usdoj.gov