What causes acute severe pancreatitis?

Written by Li Qiang
Intensive Care Unit
Updated on February 20, 2025
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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 Zhu Dan Hua
Gastroenterology
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What is acute pancreatitis and is it serious?

Acute pancreatitis is relatively common in clinical practice, which generally refers to inflammatory changes in the pancreas caused by various reasons, such as exudation and necrosis of the pancreas. Depending on the condition, it is divided into mild and severe pancreatitis. Generally, mild pancreatitis has a good prognosis with a treatment period of about one to two weeks through conservative medical treatment, and it typically heals on its own. However, severe pancreatitis with accompanying organ failure, such as liver, kidney, or respiratory failure, or the presence of local complications like abscesses, fever, pseudocysts, obstruction, etc., generally has a longer treatment period, poorer prognosis, and higher treatment costs. Therefore, the treatment outcomes vary depending on the severity and urgency of the acute pancreatitis. It is recommended that patients considering acute pancreatitis should continue diagnosis and treatment at a local hospital. Particular attention must be given to severe pancreatitis.

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Written by Wu Hai Wu
Gastroenterology
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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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Written by Li Qiang
Intensive Care Unit
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What is acute severe pancreatitis?

Acute severe pancreatitis is caused by many reasons, including binge eating, especially consuming a large amount of high-fat diet, excessive drinking, obstruction of the pancreatic duct by gallstones in the bile duct, pregnancy, hyperlipidemia, etc. These lead to disorders in pancreatic secretion, resulting in pancreatic juices digesting the pancreas itself and leaking into the abdominal cavity, leading to symptoms such as abdominal effusion. It is classified as severe pancreatitis based on reaching a certain score in some assessments. Severe pancreatitis often accompanies dysfunction of organ systems, common examples include acute respiratory distress syndrome characterized by stubborn hypoxia and respiratory failure, acute renal failure shown by anuria or oliguria, and acute gastrointestinal failure, which manifests as high abdominal pressure and severe intestinal motility disorders, including abdominal distension.

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Written by He Zong Quan
General Surgery
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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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Written by He Zong Quan
General Surgery
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How long does it take to recover from mild acute pancreatitis?

After an acute pancreatitis attack, most require fasting, gastrointestinal decompression, acid suppression, enzyme inhibition, fluid replenishment, and maintenance of water and electrolyte balance to achieve early recovery from pancreatitis. After the onset of acute pancreatitis, it is first necessary to understand the cause of pancreatitis. Many patients have biliary pancreatitis, and some are considered to be caused by alcohol or hyperlipidemia. Depending on the type of pancreatitis, the course of the disease may vary. Clinically, the most common biliary pancreatitis caused by gallstones generally improves with conservative treatment. In most cases, the condition can be controlled within about three days and recovery can occur within a week, whereas pancreatitis caused by hyperlipidemia or alcohol may take about ten days to control the progression of the disease.