Which department should I go to for acute pancreatitis?

Written by Yang Chun Guang
Gastroenterology
Updated on September 16, 2024
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If acute pancreatitis occurs, it is recommended to register with the Department of Gastroenterology. Acute pancreatitis is generally divided into acute edematous pancreatitis and acute necrotizing pancreatitis. The common form of pancreatitis in daily life is acute edematous pancreatitis, which can be treated conservatively with medication in the gastroenterology department. If acute necrotizing pancreatitis occurs, surgery may be required. In such cases, after registering with the gastroenterology department and identifying a severe condition, an appropriate transfer to another department for treatment can be made. After all, when initially arriving at the hospital, without a detailed examination, it is unclear whether it is edematous or necrotic pancreatitis.

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Written by Wei Shi Liang
Intensive Care Unit
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Severe pancreatitis symptoms

Severe pancreatitis, due to different stages of pathological changes, presents diverse systemic responses. Generally, mild symptoms of pancreatitis include abdominal pain, nausea, vomiting, and fever. In severe pancreatitis, apart from these symptoms, due to bleeding, necrosis, and autolysis of the pancreas, additional symptoms such as shock, high fever, jaundice, abdominal distension, and paralytic ileus, peritoneal irritation signs, and subcutaneous ecchymosis may also occur. Abdominal pain is the earliest symptom, while nausea and vomiting are manifestations due to inflammatory factors stimulating the vagus nerve. The likelihood of jaundice is relatively low in acute edematous pancreatitis but is more common in severe pancreatitis. Extensive inflammatory exudation in the pancreas can lead to pancreatic necrosis and localized abscesses, which may cause varying degrees of fever increase.

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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 Wei Shi Liang
Intensive Care Unit
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Severe Pancreatitis Criteria

Acute pancreatitis with persistent organ failure lasting more than 48 hours is considered severe pancreatitis. In the early stages of the disease, organ failure starts with a systemic inflammatory response produced by the activation of a cytokine cascade, involving the continuous failure of single or multiple organs. Such patients often have one or more local complications, with organ failure that can persist for several days after onset. The mortality rate can reach 36% to 50% once organ failure occurs. Infections in such patients can dramatically increase the mortality rate. CT imaging may show gas bubbles in peripancreatic necrotic tissue and fluid collections. Diagnosis is confirmed by positive results from either a smear of aspirate obtained via image-guided fine-needle aspiration or from bacterial cultures.

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Written by Wei Shi Liang
Intensive Care Unit
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Severe pancreatitis is what disease

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 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.