Where does pancreatitis hurt?

Written by Ren Zheng Xin

Gastroenterology

Updated on April 17, 2025

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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.)

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Written by Wei Shi Liang

Intensive Care Unit

1min 22sec

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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 Zhu Dan Hua

Gastroenterology

1min 9sec

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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

1min 21sec

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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 Wang Li Bing

Intensive Care Medicine Department

53sec

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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.

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Written by Li Qiang

Intensive Care Unit

1min 25sec

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How do you get acute severe pancreatitis?

There are many causes of acute severe pancreatitis, and the mechanisms of onset are not completely the same. Biliary pancreatitis is caused by small gallstones falling into the bile duct, becoming lodged at the distal end of the duct. At this time, the opening of the pancreatic duct is blocked, causing a disorder in pancreatic juice secretion, increasing pancreatic duct pressure, and spilling out of the pancreatic duct. This can corrode pancreatic cells and other abdominal organ cells. Alcohol and drug-induced pancreatitis is due to the direct damage of alcohol and drugs to the pancreatic cells, causing the leakage of pancreatic secretions. Overeating-induced pancreatitis is caused by consuming too much food at once, especially a high-fat diet, leading to a massive secretion of pancreatic juice. If there is an obstacle in the expulsion of this juice, it can also lead to pancreatitis. Hyperlipidemic pancreatitis is caused by excessively high blood lipid levels, which form blockages. These lipids obstruct the secretion of the pancreatic duct, causing pancreatitis. In all types of pancreatitis, the leakage of pancreatic secretions corrodes the pancreatic cells and these secretions enter the abdominal cavity, corroding abdominal organs and leading to a series of severe inflammatory responses and potentially leading to abdominal infections.