Can severe pancreatitis be cured?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 27, 2024
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Severe pancreatitis can be cured, but because its complications are severe, it may be life-threatening. Severe pancreatitis is caused by a variety of etiologies leading to local inflammation, necrosis, and infection of the pancreas, accompanied by systemic inflammatory responses and persistent organ failure. Currently, comprehensive treatment for severe pancreatitis has become very mature, but its mortality rate is still as high as 17%. Currently, with a deeper understanding of the pathology, physiology, and disease progression of severe pancreatitis, there have been advances in treatment modalities, treatment concepts, and means of organ function support for severe pancreatitis. However, the mortality rate for severe pancreatitis remains high, though it can still be cured.

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Written by Li Qiang
Intensive Care Unit
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The difference between severe pancreatitis and mild pancreatitis

Generally speaking, mild pancreatitis is just a local inflammation of the pancreas, usually manifested as upper abdominal pain, nausea, vomiting, and bloating — symptoms of the gastrointestinal tract. Severe pancreatitis, however, is much more serious than mild pancreatitis. In severe pancreatitis, not only is the pain in the local pancreas area more intense and the abdominal bloating more pronounced, but there is also a lot of effusion accumulating in the abdomen. Severe pancreatitis can also affect many other organs, such as the lungs, which are most commonly affected. It can lead to patients developing acute respiratory distress syndrome, characterized by severe hypoxemia, with many patients requiring mechanical ventilation treatment. Another organ that is commonly affected is the kidney, with many patients with severe pancreatitis experiencing acute renal failure, reduced urine output, or even anuria. Severe pancreatitis can also affect the heart, brain, and other organs, leading to functional abnormalities in these organs. Therefore, besides affecting the local pancreas, severe pancreatitis can involve other important organs, resulting in multiple organ dysfunctions.

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Written by Zhu Dan Hua
Gastroenterology
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Severe pancreatitis treatment process

Severe pancreatitis generally develops rapidly, progresses urgently, and can even be life-threatening. Therefore, the main treatment initially involves fasting, gastrointestinal decompression, suppression of pancreatic enzyme secretion, promotion of gastrointestinal motility, and maintaining regular bowel movements. Antibiotics can be used to prevent infection and necrosis of pancreatic tissue. If necrotic pancreatic tissue and ascites occur in the abdominal cavity, appropriate puncture and drainage may be used.

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Written by Wei Shi Liang
Intensive Care Unit
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Rescue of severe pancreatitis

Severe pancreatitis involves severe illness impacting multiple systems and organs across the body. The rescue of severe pancreatitis should be based in the ICU, with multidisciplinary cooperation. The first step is early fluid resuscitation, with crystalloid solution preferred, and it should be rapidly completed within 48 hours of onset. The second step involves support for circulation and respiration. The third step involves the maintenance of organ functions and the use of blood purification treatments. Early use of blood purification in acute pancreatitis can remove inflammatory mediators, regulate immune dysfunctions, and protect organ functions, potentially extending the survival time of patients with severe pancreatitis. The fourth step includes monitoring intra-abdominal pressure and preventing and treating abdominal compartment syndrome. Further treatments mainly include the use of agents to inhibit pancreatic enzymes and platelet activation, as well as early jejunal nutrition. Additionally, prophylactic use of antibiotics is required, and in cases of biliary acute pancreatitis, ERCP or sphincterotomy should be performed. The final approach is surgical treatment, which is reserved for patients who do not respond to or have poor results from conservative treatment.

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Written by Ren Zheng Xin
Gastroenterology
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Where does pancreatitis hurt?

Pancreatitis refers to the disease caused by the digestion of its own tissues by pancreatic fluid, with the main symptoms being pain, vomiting, and nausea. The pain is generally located in the upper left abdomen and can radiate to the left shoulder or left back. If it is biliary pancreatitis, there is generally pain in the upper right abdomen that gradually moves to the left side, may involve the entire abdomen, and radiates to the back in a belt-like manner. It often occurs suddenly after a full meal or drinking alcohol. The abdominal pain is very severe and unbearable, and active medication treatment should be used. (Specific medications should be used under the guidance of a physician.)