Acute pancreatitis clinical manifestations and signs

Written by Zhu Dan Hua
Gastroenterology
Updated on September 01, 2024
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The clinical manifestations of acute pancreatitis generally present as upper abdominal pain, with some patients also experiencing fever, nausea, vomiting, and pain in the lumbar and back areas. In terms of physical signs, the main ones are abdominal distension and tenderness in the upper abdomen, with abdominal pain being the most commonly seen symptom in clinical settings. This pain is typically in the upper abdomen, persistent, and difficult to alleviate, although bending forward may provide some relief for the patient; some patients may also experience symptoms of vomiting. Diagnosis of the condition primarily relies on blood and urine amylase levels and imaging studies. Typically, an ultrasound and CT scan of the abdomen are completed, which can reveal typical changes associated with acute pancreatitis, such as effusion, etc. Treatment, for now, involves enzyme inhibition, fasting, acid suppression, fluid replacement, and other symptomatic treatments. Generally, the acute phase of pancreatitis can be controlled within five to seven days, but if severe pancreatitis is considered, the treatment period may be longer. (The use of medication should be under the guidance of a physician.)

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Written by Zhu Dan Hua
Gastroenterology
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What department should I go to for acute pancreatitis?

Acute pancreatitis can be treated at the Department of Gastroenterology in local hospitals. It commonly begins with abdominal pain clinically, so it is recommended that patients first visit the Department of Gastroenterology. The pain from acute pancreatitis is primarily in the upper abdomen, persistent, and may radiate to the back. Of course, some patients may experience nausea, vomiting, cessation of gas and bowel movements, fever, etc. For such patients, it is recommended to complete examinations such as blood amylase, urine amylase, and lipase. When necessary, an abdominal ultrasound and CT scan should be conducted to assess the condition of the pancreatitis. Diagnosing pancreatitis is generally straightforward. As for treatment, it mainly involves internal medicine pharmacotherapy, fasting, fluid replacement, gastrointestinal decompression, and suppressing pancreatic secretion, among others. Of course, if complications arise, surgical intervention by the Department of Hepatobiliary Surgery may be required. (The use of medication should be under the guidance of a doctor.)

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Written by Li Qiang
Intensive Care Unit
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How long does it take to cure acute severe pancreatitis?

Acute severe pancreatitis is a disease with a long treatment period and high treatment costs. Acute severe pancreatitis is pathologically staged, generally divided into the organ failure phase, also known as the inflammatory response phase. Typically, this occurs within 7 days after the onset of severe pancreatitis, during which there is a massive release of inflammatory factors, causing multiple organ failures. This stage is perilous and often requires the support of multiple organ functions, such as ventilators and hemofiltration treatments. After this inflammatory response phase, it transitions into a chronic phase of abdominal infection, which occurs approximately one week to one or two months after the onset. At this time, there is a large amount of effusion in the abdominal cavity, and some of the effusion may develop secondary infections. The main treatment at this stage involves puncture drainage of the effusion. Once an infection is detected, puncture drainage is performed on the infected site to manage the infection. Therefore, the treatment period for severe pancreatitis primarily depends on the duration of organ function support, recovery time of organ functions, and the severity of the infection. Some organ function support may be prolonged, requiring several months, and sometimes irreversible conditions occur, such as acute renal failure transitioning into chronic renal failure. Abdominal infections are more complex. If the infection is severe and recurrent, long-term puncture drainage or surgical removal of the infection may be necessary, often requiring several months of treatment.

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Written by Wei Shi Liang
Intensive Care Unit
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Is acute severe pancreatitis serious?

Acute severe pancreatitis is a very serious disease in clinical practice, with a high mortality rate, often requiring comprehensive treatment in the ICU. Acute severe pancreatitis is a disease caused by multiple etiologies that results in localized inflammation, necrosis, and infection of the pancreas, accompanied by a systemic inflammatory response and persistent organ failure. It is divided into three phases. The first phase is the acute response phase, occurring from onset to about two weeks, characterized by systemic inflammatory response; the second phase is the systemic infection phase, occurring from two weeks to about two months, characterized by necrosis and infection of the pancreas or peripancreatic tissues; the third phase is the residual infection phase, occurring two to three months later, with clinical manifestations primarily of systemic malnutrition and persistent fistulas, accompanied by gastrointestinal fistulas.

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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 Wu Hai Wu
Gastroenterology
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Can acute pancreatitis patients have sexual intercourse?

Patients with acute pancreatitis cannot have sexual intercourse during the acute treatment period because it can lead to physical exhaustion and further weaken the patient's condition. Therefore, during the acute phase of acute pancreatitis, the focus should be on rest, and the diet should include foods rich in vitamins and carbohydrates, such as starchy foods, fresh vegetables, and fruits. It is important to avoid overeating, greasy foods, and alcohol consumption. If patients with acute pancreatitis recover fully, and their physical strength is completely restored, they may then consider resuming sexual activity.