How is acute pancreatitis treated?

Written by Chen Rong
Gastroenterology
Updated on September 18, 2024
00:00
00:00

Acute pancreatitis is classified into mild pancreatitis and severe pancreatitis depending on the severity of the condition. Mild cases often recover within a week without residual effects; severe cases are perilous with a poor prognosis, and the mortality rate ranges from 20% to 40%. Treatment for mild pancreatitis includes fasting, gastrointestinal decompression, pain relief, antibiotics, intravenous nutrition, acid suppression, enzyme inhibition, etc. In addition to the aforementioned treatments, severe pancreatitis requires strict medical monitoring to maintain electrolyte balance, early parenteral nutrition transitioning to enteral nutrition, and the use of antibiotics to reduce pancreatic fluid secretion, such as the growth inhibitor octreotide, as well as enzyme activity suppressants like gabexate. If the pancreatitis is biliary in origin, an ERCP with a sphincterotomy of the sphincter of Oddi may be performed. In case of serious complications, surgical treatment may be considered. (Medications should be used under the guidance of a doctor.)

Other Voices

doctor image
home-news-image
Written by Yang Chun Guang
Gastroenterology
51sec home-news-image

Which department should I go to for acute pancreatitis?

If acute pancreatitis occurs, it is recommended to register with the Department of Gastroenterology. Acute pancreatitis is generally divided into acute edematous pancreatitis and acute necrotizing pancreatitis. The common form of pancreatitis in daily life is acute edematous pancreatitis, which can be treated conservatively with medication in the gastroenterology department. If acute necrotizing pancreatitis occurs, surgery may be required. In such cases, after registering with the gastroenterology department and identifying a severe condition, an appropriate transfer to another department for treatment can be made. After all, when initially arriving at the hospital, without a detailed examination, it is unclear whether it is edematous or necrotic pancreatitis.

doctor image
home-news-image
Written by Wu Hai Wu
Gastroenterology
47sec home-news-image

Can pancreatitis be contagious?

Pancreatitis is not contagious; it is a serious digestive system disease. The main causes of pancreatitis include gallstones, binge eating, alcohol abuse, and consumption of greasy foods among other factors. Once an attack of pancreatitis occurs, the patient must immediately refrain from eating and drinking, undergo gastrointestinal decompression, and have gastric juices, acids, and stomach contents suctioned out. Meanwhile, treatments for pancreatitis may involve the use of somatostatin or octreotide to inhibit the secretion of pancreatic juice, as well as the use of third-generation cephalosporins or quinolone antibiotics for anti-infection treatment. (Please use medications under the guidance of a physician.)

doctor image
home-news-image
Written by Wang Li Bing
Intensive Care Medicine Department
53sec home-news-image

Severe pancreatitis diagnostic criteria

Diagnostic criteria for severe pancreatitis: First, based on the patient's clinical symptoms, symptoms such as restlessness, cold limbs, and mottled skin, indicative of shock, may appear. Second, physical examination signs, such as rigid abdominal muscles indicative of a positive peritoneal irritation sign, and Grey Turner's sign may also be present. Third, according to laboratory tests, the calcium levels generally significantly decrease, usually below 2 mmol/L, and elevated blood sugar levels greater than 11.2 mmol/L, typically without a history of diabetes. There may also be a sudden decrease in urine amylase. Fourth, diagnostic abdominal paracentesis reveals ascitic fluid with high amylase activity. Based on these points, severe pancreatitis can be considered.

doctor image
home-news-image
Written by Zhu Dan Hua
Gastroenterology
1min 7sec home-news-image

Pancreatitis is what?

Pancreatitis is a relatively common disease in gastroenterology, generally believed to be caused by various factors leading to the activation and autodigestion of the pancreas itself, resulting in inflammatory changes in the pancreas. Common causes include bile duct stones, alcohol consumption, and overeating, among others. Clinically, it is most commonly presented with symptoms such as abdominal pain, bloating, nausea, and vomiting. Fever may also accompany these symptoms. The diagnostic criteria for pancreatitis generally include three standards: The first is typical upper abdominal pain, persistent upper abdominal pain; the second is a blood test showing blood amylase levels more than three times the normal value; the third involves typical abdominal imaging, such as ultrasound, CT, or MRI, indicating imaging changes like pancreatic effusion. If two out of these three criteria are met, pancreatitis can generally be diagnosed.

doctor image
home-news-image
Written by Chen Rong
Gastroenterology
1min 25sec home-news-image

How to check for pancreatitis?

The examination of pancreatitis requires laboratory tests and imaging examinations to assess the severity of the condition and to identify the cause. Elevated amylase and lipase levels more than three times the normal values, increased white blood cells, elevated C-reactive protein, increased blood sugar, elevated transaminases and bilirubin, decreased albumin, increased urea nitrogen and creatinine, decreased blood oxygen partial pressure, decreased blood calcium, elevated triglycerides, and abnormalities in blood sodium, potassium, and pH values all reflect the severity of pancreatitis. Abdominal ultrasound is a routine initial screening imaging examination for acute pancreatitis, and abdominal CT is helpful in confirming the presence of pancreatitis, peripancreatic inflammatory changes, and pleural effusion. Enhanced CT is beneficial in determining the extent of pancreatic necrosis and is generally performed about a week after the onset of the condition. However, when searching for the cause of pancreatitis, the sensitivity and accuracy of CT are not as good as MRI, therefore further MRI should be conducted to investigate causes related to the bile duct and to determine the cause of the pancreatitis.