Severe pancreatitis is what disease

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 23, 2024
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Acute severe pancreatitis is a disease caused by various etiologies, characterized by local necrosis, inflammation, and infection of the pancreas, accompanied by systemic inflammatory response and persistent organ failure. The current mortality rate is still as high as 17%.

The course of acute severe pancreatitis can generally be divided into three periods. First, the acute response period, occurring up to about two weeks after onset, is characterized by a systemic inflammatory response. Second, the systemic infection period, from two weeks to about two months, is characterized by infection of pancreatic or peripancreatic necrosis. Third, the residual infection period, occurring two to three months later, where the main clinical manifestation is systemic malnutrition.

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Written by Zhu Dan Hua
Gastroenterology
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Where does pancreatitis hurt?

Pancreatitis generally presents as abdominal pain, specifically in the upper abdomen, the area above the navel, and near the xiphoid process. The pain is usually continuous and may intensify intermittently. Some patients also experience intolerable radiating pain in the lumbar and back areas, which can improve when they bend over. Patients commonly experience nausea and vomiting, which typically involve stomach contents without blood. Some patients may also have a fever, most commonly a low-grade fever between 37°C and 38.5°C. Patients usually seek medical attention for abdominal pain, and the pain in the upper abdomen and back area is a common complaint. To further clarify the diagnosis, patients typically need to undergo tests such as amylase evaluation, abdominal CT, and abdominal ultrasound. After these tests, a diagnosis of pancreatitis can usually be made. Treatment initially focuses on symptomatic management and medical treatment.

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Written by Si Li Li
Gastroenterology
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How to treat mild pancreatitis

Pancreatitis occurs due to the abnormal activation of pancreatic enzymes, leading to the self-digestion of the pancreas. The primary causes include alcohol, where excessive drinking can induce acute pancreatitis. Another cause is hyperlipidemia, as individuals with high blood lipid levels are prone to acute pancreatitis. Additionally, cholelithiasis, including stones in both the bile ducts and the gallbladder, can also trigger acute pancreatitis. Symptoms of acute pancreatitis manifest as severe pain in the upper abdomen, accompanied by nausea, vomiting, abdominal bloating, and fever. Acute pancreatitis is classified into mild, moderate, and severe categories. Mild cases mainly exhibit edema of the pancreas without bleeding, necrosis, or involvement of other organs. Treatment primarily involves fasting and fluid replacement, typically lasting for more than 48 hours or until abdominal pain ceases. Another aspect of treatment is inhibiting pancreatic enzyme secretion. Some patients with acute pancreatitis might also need antibiotics. Typically, mild acute pancreatitis can heal within one to two weeks of treatment.

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Written by Wei Shi Liang
Intensive Care Unit
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Principles of Treatment for Severe Acute Pancreatitis

The treatment of severe pancreatitis requires care in an ICU, involving a multidisciplinary team. Early treatment of severe pancreatitis focuses on non-surgical management centered on organ function support, and sterile necrosis is preferably treated non-surgically. Surgical treatment is applied once necrotic infection occurs. Non-surgical treatment principally involves intensive care monitoring and mainly consists of fluid replacement, maintenance of electrolyte and acid-base balance, energy support, and prevention of local and systemic complications. Additionally, current non-surgical treatments for severe pancreatitis include bedside blood filtration, abdominal lavage, etc. Moreover, minimally invasive treatments are supplementary methods for managing severe pancreatitis, including biliary drainage, minimally invasive techniques, and treatment of infected pancreatic necrosis. Surgical intervention, involving the removal of necrotic tissue, is necessary during the infection phase.

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Written by Yang Chun Guang
Gastroenterology
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What medicine is used for pancreatitis?

In clinical practice, it is advised that patients with pancreatitis be hospitalized for treatment. The primary medications used during hospitalization mainly involve nutritional support, as patients with pancreatitis cannot eat and must refrain from ingesting food and water, necessitating the supplementation of water and electrolyte balance. Treatment primarily consists of using medications that reduce pancreatic secretion, such as choosing octreotide or similar drugs. Other drugs can be combined to inhibit pancreatic enzyme activity. However, while using these medications, it is important to consider using antibiotics to prevent infections in cases of pancreatitis. Overall, it is crucial to receive standardized treatment in a hospital for pancreatitis, as the condition can change rapidly and is relatively dangerous. (The use of medications should be under the guidance of a doctor.)

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Written by Chen Rong
Gastroenterology
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Is pancreatitis contagious?

Pancreatitis is a condition where pancreatic tissue damage is caused by self-digestion due to various etiologies. It can be seen in multiple causes and is not a contagious disease itself and does not spread. However, when pancreatitis is caused by infectious diseases such as acute epidemic mumps, influenza A infection, Chlamydophila pneumoniae infection, infectious mononucleosis, Coxsackie virus infection, etc., the pancreas can be affected as a target organ resulting in pancreatitis. In such cases, transmission of the primary disease may occur, but pancreatitis is more commonly associated with biliary diseases such as cholelithiasis, biliary infection, alcohol damage, pancreatic duct obstruction (like pancreatic duct stones, ascariasis, stricture, tumors), diseases of the descending part of the duodenum (such as post-bulbar perforation, ulcers, adjacent papillitis of the duodenum, surgical trauma), hyperlipidemia, autoimmune diseases, drug damage, etc., none of which are contagious.