Acute pancreatitis

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Written by Guo Li Ming
Gastroenterology
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What are the causes of acute pancreatitis?

There are many causes of acute pancreatitis. Common primary causes include improper diet: overeating, alcohol consumption, preference for spicy or rich foods, etc. Additionally, hyperlipidemia and cholelithiasis are also reasons, along with surgical trauma such as cholangiography, gastrectomy, etc. Other diseases can also lead to acute pancreatitis, such as hypercalcemia, diabetic coma, hyperparathyroidism, rheumatism, necrotizing vasculitis, etc.; viral infections can also cause pancreatitis, and long-term use of medications can cause acute inflammation, such as tetracycline, corticosteroids, etc. Acute pancreatitis initially presents with severe, acute abdominal pain, commonly in the left, upper middle quadrant, and occasionally radiating to the back. Subsequently, vomiting, fever, and in severe cases, shock may occur. Acute pancreatitis is a type of acute abdomen and can be life-threatening. If symptoms occur, it is crucial to seek immediate hospital treatment.

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Written by He Zong Quan
General Surgery
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Does acute pancreatitis affect the rise in blood sugar?

After the onset of acute pancreatitis, pathological changes occur in the pancreas, affecting both its endocrine and exocrine functions. The endocrine function includes the secretion of insulin, which can lead to insulin resistance, impacting glucose metabolism and causing an increase in blood sugar levels. Therefore, after admission, it is routine to monitor the blood sugar levels of patients with acute pancreatitis and manage insulin resistance. Additionally, due to the increased blood sugar levels, there is a higher risk of infection in these patients. Depending on the cause of the condition, targeted treatment is necessary along with the early use of antibiotics to control the progression of pancreatitis, reduce the rate of infections, and promote recovery of the body.

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Written by He Zong Quan
General Surgery
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Does acute pancreatitis have anything to do with the stomach?

Acute pancreatitis is not closely related to stomach conditions, although it is sometimes associated with overeating, but it is not caused by stomach diseases in patients. Instead, it relates to lifestyle habits. The occurrence of pancreatitis is often considered to be due to biliary, alcoholic, hyperlipidemia, and idiopathic causes. In China, the most common causes are biliary and alcohol-related. Biliary causes are mainly related to gallstones, while alcohol-related causes are mostly associated with drinking. Common stomach diseases include gastritis, ulcers, and stomach cancer. These conditions can sometimes cause an increase in amylase during acute abdominal conditions, but they do not cause acute pancreatitis.

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Written by Li Qiang
Intensive Care Unit
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What causes acute severe pancreatitis?

There are many causes of severe pancreatitis, including the following: The first type is alcoholic pancreatitis, which is caused by heavy drinking leading to pancreatic damage. The second type is pancreatitis due to overeating, where consuming large amounts of food, especially high-fat foods, leads to excessive secretion by the pancreas, resulting in pancreatitis. Another type is biliary pancreatitis, caused by small gallstones from the gallbladder falling into the bile duct. Stones lodged at the opening of the pancreatic and bile ducts cause a secretion disorder in the pancreas, leading to pancreatitis. There is also hyperlipidemic pancreatitis, seen in pregnant women and patients with familial hyperlipidemia. Hyperlipidemia causes blockage of the pancreatic duct, thereby triggering an episode of pancreatitis. Another is traumatic pancreatitis, which is directly caused by external forces leading to compression or contusion injuries of the pancreas. Lastly, there is drug-induced pancreatitis, which occurs when certain medications have a direct toxic effect on the pancreas, causing damage to the pancreatic cells.

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Written by Li Qiang
Intensive Care Unit
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How do you get acute severe pancreatitis?

There are many causes of acute severe pancreatitis, and the mechanisms of onset are not completely the same. Biliary pancreatitis is caused by small gallstones falling into the bile duct, becoming lodged at the distal end of the duct. At this time, the opening of the pancreatic duct is blocked, causing a disorder in pancreatic juice secretion, increasing pancreatic duct pressure, and spilling out of the pancreatic duct. This can corrode pancreatic cells and other abdominal organ cells. Alcohol and drug-induced pancreatitis is due to the direct damage of alcohol and drugs to the pancreatic cells, causing the leakage of pancreatic secretions. Overeating-induced pancreatitis is caused by consuming too much food at once, especially a high-fat diet, leading to a massive secretion of pancreatic juice. If there is an obstacle in the expulsion of this juice, it can also lead to pancreatitis. Hyperlipidemic pancreatitis is caused by excessively high blood lipid levels, which form blockages. These lipids obstruct the secretion of the pancreatic duct, causing pancreatitis. In all types of pancreatitis, the leakage of pancreatic secretions corrodes the pancreatic cells and these secretions enter the abdominal cavity, corroding abdominal organs and leading to a series of severe inflammatory responses and potentially leading to abdominal infections.

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Written by He Zong Quan
General Surgery
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How long will the fever last in acute pancreatitis?

Patients with acute pancreatitis may experience different symptoms based on the cause of the pancreatitis and the staging of the patient's condition. A fever in acute pancreatitis indicates a severe infection. If a CT scan shows extensive pancreatic effusion, coupled with hyperglycemia and hypocalcemia, it suggests that the condition is severe and there is a tendency towards severe pancreatitis. This type of fever generally requires treatment, sometimes even surgical intervention, and usually takes about half a month to a month to subside. If the fever is caused solely by biliary pancreatitis due to bile duct obstruction by gallstones, and surgical intervention to remove the obstruction is performed, the fever will typically diminish significantly in the short term.

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Written by Si Li Li
Gastroenterology
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Dietary care for acute pancreatitis

Symptoms of acute pancreatitis include severe upper abdominal pain. During the treatment, it is essential to fast and decompress the stomach and intestines initially during the abdominal pain period. Once the pain subsides, the patient can begin a liquid diet, followed by a gradual transition to a semi-liquid diet under the guidance of a doctor. Since the causes of acute pancreatitis include binge eating or excessive alcohol consumption, patients with acute pancreatitis should abstain from alcohol and maintain a balanced diet to prevent binge eating. A light diet is preferable, avoiding fatty, greasy, fried, and barbecued foods. Additionally, it is important to maintain regular rest patterns and avoid excessive fatigue or staying up late.

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Written by He Zong Quan
General Surgery
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Can acute pancreatitis turn into pancreatic cancer?

Acute pancreatitis and pancreatic cancer are two diseases that occur in the same organ, the pancreas. However, acute pancreatitis is entirely an inflammatory change, often caused by gallstones, alcohol consumption, binge eating, and hyperlipidemia, with some cases being idiopathic. Pancreatic cancer, on the other hand, is a tumorous lesion and is a malignant tumor that generally requires surgery. Many pancreatic cancer patients are already in the advanced stages when discovered, making the surgery difficult to perform. The prognosis for patients is also completely different. After the onset of acute pancreatitis and treatment, the pancreas recovers, the inflammation subsides, and it does not affect a person's lifespan. However, if pancreatic cancer is clearly diagnosed, the lifespan oftentimes does not extend beyond a few years.

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Written by Li Qiang
Intensive Care Unit
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How long does it take to cure acute severe pancreatitis?

Acute severe pancreatitis is a disease with a long treatment period and high treatment costs. Acute severe pancreatitis is pathologically staged, generally divided into the organ failure phase, also known as the inflammatory response phase. Typically, this occurs within 7 days after the onset of severe pancreatitis, during which there is a massive release of inflammatory factors, causing multiple organ failures. This stage is perilous and often requires the support of multiple organ functions, such as ventilators and hemofiltration treatments. After this inflammatory response phase, it transitions into a chronic phase of abdominal infection, which occurs approximately one week to one or two months after the onset. At this time, there is a large amount of effusion in the abdominal cavity, and some of the effusion may develop secondary infections. The main treatment at this stage involves puncture drainage of the effusion. Once an infection is detected, puncture drainage is performed on the infected site to manage the infection. Therefore, the treatment period for severe pancreatitis primarily depends on the duration of organ function support, recovery time of organ functions, and the severity of the infection. Some organ function support may be prolonged, requiring several months, and sometimes irreversible conditions occur, such as acute renal failure transitioning into chronic renal failure. Abdominal infections are more complex. If the infection is severe and recurrent, long-term puncture drainage or surgical removal of the infection may be necessary, often requiring several months of treatment.

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Written by He Zong Quan
General Surgery
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Causes of vomiting in acute pancreatitis

Acute pancreatitis vomiting has various causes. Firstly, the pancreas is a digestive organ, and upon the onset of pancreatitis, a large amount of pancreatic enzymes is secreted, which significantly affects digestive functions. This easily causes gastrointestinal reactions, and if undigested stomach contents remain in the stomach cavity for too long, it will increase stomach cavity pressure, leading to frequent vomiting. The vomiting caused by acute pancreatitis generally does not alleviate symptoms after vomiting. The treatment primarily targets acute pancreatitis, including enzyme inhibition, acid suppression, and fasting to help reduce vomiting. The occurrence of vomiting is also related to increased intra-abdominal pressure. Following the onset of acute pancreatitis, if treatment is not timely, it can lead to increased intra-abdominal pressure. This increase in pressure can affect gastrointestinal motility, causing reflexive symptoms of nausea and vomiting.