Is acute severe pancreatitis serious?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 16, 2024
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Acute severe pancreatitis is a very serious disease in clinical practice, with a high mortality rate, often requiring comprehensive treatment in the ICU. Acute severe pancreatitis is a disease caused by multiple etiologies that results in localized inflammation, necrosis, and infection of the pancreas, accompanied by a systemic inflammatory response and persistent organ failure. It is divided into three phases. The first phase is the acute response phase, occurring from onset to about two weeks, characterized by systemic inflammatory response; the second phase is the systemic infection phase, occurring from two weeks to about two months, characterized by necrosis and infection of the pancreas or peripancreatic tissues; the third phase is the residual infection phase, occurring two to three months later, with clinical manifestations primarily of systemic malnutrition and persistent fistulas, accompanied by gastrointestinal fistulas.

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Is it normal to have a fever with acute pancreatitis?

Acute pancreatitis often occurs following gallstones, hyperlipidemia, and alcohol consumption. Patients with acute pancreatitis sometimes exhibit clear symptoms, including fever. This is due to the significant inflammatory irritation and the extravasation of pancreatic juices, causing infection and effusion around the pancreatic tissue. If not treated promptly, the fever may persist. Therefore, after diagnosing acute pancreatitis, treatments such as dietary restrictions, gastrointestinal decompression, enzyme inhibition, acid suppression, correction of fluid and electrolyte balance, and anti-infection measures should be taken. These treatments can delay or alleviate the progression of acute pancreatitis and help the patient's body recover sooner, thereby reducing the fever.

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Is the recurrence rate of acute pancreatitis high?

After recovering from acute pancreatitis, if patients do not pay careful attention to their diet, there is a significant risk of relapse. For example, they should not drink alcohol excessively, overeat, or consume greasy foods. Also, if the acute pancreatitis is caused by conditions such as gallstones, it is important to have the gallbladder removed promptly. Without gallbladder removal, the recurrence rate of the disease noticeably increases. Patients with acute pancreatitis should initially eat foods that are easy to digest and low in protein and fat, such as carbohydrates that are also easy to swallow. Once the patient's condition significantly improves, they can gradually transition to a diet higher in protein and vitamins, among other nutrients.

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Can you drink water with acute pancreatitis?

Patients with acute pancreatitis cannot drink water or eat anything during the acute phase. They must undergo gastrointestinal decompression to suction out gastric juice, gastric acid, and gastric contents. At the same time, treatment for acute pancreatitis includes inhibiting pancreatic secretion, anti-infection measures, intravenous fluid replenishment, and maintaining electrolyte balance, among others. If a patient with acute pancreatitis experiences bowel movements, gas, relief from abdominal pain, and a decrease in blood amylase to normal levels, they may then consider drinking small amounts of water and consuming light foods like rice soup or thin porridge. If the abdominal pain disappears, the patient can gradually increase their water intake.

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How long after being discharged with acute pancreatitis can one resume a normal diet?

After being discharged from the hospital, patients with acute pancreatitis, upon re-examination of routine blood tests and upper abdominal CT scans showing complete healing of pancreatitis, may, as appropriate, consume a low-fat, high-carbohydrate diet and gradually transition back to a normal diet. This process generally requires at least two months to be considered safe. Patients discharged after acute pancreatitis must abstain strictly from alcohol, avoid binge eating, and avoid overly greasy food. Greasy food can easily lead to increased bile discharge and potentially cause blockage of the pancreas, possibly triggering a recurrence of pancreatitis.

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What department should I go to for acute pancreatitis?

Acute pancreatitis can be treated at the Department of Gastroenterology in local hospitals. It commonly begins with abdominal pain clinically, so it is recommended that patients first visit the Department of Gastroenterology. The pain from acute pancreatitis is primarily in the upper abdomen, persistent, and may radiate to the back. Of course, some patients may experience nausea, vomiting, cessation of gas and bowel movements, fever, etc. For such patients, it is recommended to complete examinations such as blood amylase, urine amylase, and lipase. When necessary, an abdominal ultrasound and CT scan should be conducted to assess the condition of the pancreatitis. Diagnosing pancreatitis is generally straightforward. As for treatment, it mainly involves internal medicine pharmacotherapy, fasting, fluid replacement, gastrointestinal decompression, and suppressing pancreatic secretion, among others. Of course, if complications arise, surgical intervention by the Department of Hepatobiliary Surgery may be required. (The use of medication should be under the guidance of a doctor.)