Pancreatic tissues are damaged by various causes and different enzymes that are supposed to digest food come into play in advance, which do not digest food, and digest the pancreas instead. Such “suicide” leads to a series of results which are referred to as pancreatitis. The morbidity of pancreatitis is 1.86:1 among men and women, and men tend to have higher morbidity since men usually have unhealthy living habits such as smoking, alcohol drinking and overeating.
Acute pancreatitis
Why do people get acute pancreatitis?
The pathogeneses of acute pancreatitis include cholelithiasis which causes duodenal ampulla obstruction, leading to the reflux of bile into the pancreatic duct where inactive trypsinogen is activated into trypsin; the stimulation of overeating and alcohol leads to hypersecretion of pancreatic juice etc.
There are many inducing factors to pancreatitis, including biliary calculi, heavy drinking, abdominal trauma, overeating, hyperlipemia, various infections, drug factor and heritable variation etc., among which the factors of biliary calculi, heavy drinking and overeating are the most common factors that lead to acute pancreatitis, which shall be attached with enough importance.
Furthermore, some special drugs may cause pancreatitis, and the most common one include hormones, oral contraceptives and immunosuppressor; in addition, diuretic, hypoglycemic agents and certain antibiotics may lead to acute pancreatitis among certain people. Hereditary pancreatitis is unusual, and some cases of repetitively occurring pancreatitis are related to the structural abnormality of the pancreas.
Who are more likely to suffer from pancreatitis?
1、Patients who suffer from gallstone and repetitively occurring cholecystitis: Those patients are more likely to suffer from biliary obstruction, making their pancreatic juice unable to be regularly discharged, their pancreatic tissues are damaged and ultimately pancreatitis;
2、Long-term smoking, alcohol abuse, overeating and obesity: Long-term unhealthy living and eating habits may cause increased plasma lipid and increased blood viscosity. Overeating and alcohol consumption may cause copious secretions of pancreatic juice at once that may easily lead to obstruction and pancreatic damages.
What are the symptoms of acute pancreatitis?
Clinical symptoms include fulgurating and continuous epigastric pain, accompanied by pyrexia, nausea, emesis, increased serum activity and urine amylase activity. Sometimes yellow skin and cutaneous pruritus. Peritonitis and shock in serious cases. Occasionally subcutaneous ecchymosis below the waist and ribs and subcutaneous ecchymosis of peripheral umbilicus. Palpable masses can be formed in the abdomen due to fluid collection or pseudocyst.
Repetitively occurring acute pancreatitis may cause serious damage on pancreatic functions, and lead to chronic pancreatitis, and followed by a series of hypofunction of digestive functions.
Acute pancreatitis is a very serious disease especially acute hemorrhagic necrotic pancreatitis which is of rapid onset and high mortality.
What examinations shall I take if I am diagnosed with pancreatitis?
1、Blood test: The value of blood amylase is three times higher than the normal value; urine amylase>1000U/L; increased serum lipase; increased number of white blood cells.
2、Ultrasonic test: To find out whether you suffer from calculus of bile duct, hemorrhage of pancreas and pancreatic necrosis.
3、Abdominal CT: The most recommended test now, which is of critical value for the diagnosis of pancreatitis.
Is acute pancreatitis severe?
Acute pancreatitis is divided into three types according to different order of severity:
Mild acute pancreatitis: Most cases acute pancreatitis cases are mild and without organ failure and regional complications or systemic complications. Mild acute pancreatitis can be cured within 1-2 weeks and mortality is incredibly low.
Moderately severe acute pancreatitis: Accompanied by transient (≤48 h) organ failure. The fatality rate is low in early stages while it increases in later stages where concurrent infection of necrotic tissues may take place.
Severe acute pancreatitis: Approximately 5%-10% of AP cases are severe. Accompanied by multiple organ failures such as respiratory organs, heart and kidneys failures that last for more than 48 hours and are irreclaimable, indicating severe acute pancreatitis under such circumstances. Severe pancreatitis is a disease of rapid onset, quick progression, many complications and high mortality. It is worth noting that some diagnosed cases of mild pancreatitis may evolve into severe acute pancreatitis if not being treated timely, and serious result can be occurred. Therefore, even mild acute pancreatitis patients may not treat their conditions lightly and must strictly follow the doctor’s advice.
What therapeutic methods are there for acute pancreatitis?
Normally speaking, the doctor will inform the patient who is diagnosed with acute pancreatitis to stop eating and drinking because food intake may cause the secretion of various enzymes in the pancreas, leading to further damages. Normally, the patient shall be restricted of food intake in the first 4-7 days, and stomach tube is needed to alleviate the symptoms in the stomach and intestines if the patient has serious symptoms such as abdominal distension, nausea and emesis.
1、Certain drugs may suppress the secretions of the pancreas;
2、Patients who suffer from severe abdominal pain may take appropriate dosage analgesics;
3、Preventive use of antibiotics;
4、Receive nutrients through intravenous feeding;
5、Surgical treatment or endoscopical therapy according to actual conditions.
Is there any sequela?
Therapeutic effects may vary due to different severity and pathogenesis. Patients of mild symptoms, timely diagnosed with pathogenesis clearly confirmed can be basically cured after positive treatment; a few patients of severe symptoms may not entirely recover since it is difficult to cure, and some of them may have their life at stake. Some patients may go through repetitive onset and ultimately evolve into chronic pancreatitis which may lead to decreased appetite, abdominal distension and diarrhea, loss of weight, and malnutrition.
