What issues should be paid attention to in severe acute pancreatitis

Severe acute pancreatitis is a disease that many people have never heard of, but the occurrence of pancreatitis not only affects personal health, but also life. Patients with pancreatitis will have frequent fevers and even multiple complications. Therefore, when the condition is more serious, in addition to going to the hospital for examination, you should also find the breakthrough point of the disease. Pancreatitis is a dangerous existence, so pay attention to these issues.

Severe acute pancreatitis should pay attention to the following issues:

1. For patients with clear cholelithiasis who develop acute pancreatitis, cholelithiasis should be treated as soon as possible after the acute pancreatitis is cured to eliminate possible risk factors. But in real life, many patients are reluctant to undergo surgery after being cured of acute pancreatitis due to fear of surgery, busy work or no one to take care of them at home. In the end, acute pancreatitis recurs.

2. Hyperlipidemia is also one of the causes of recurrent attacks of acute pancreatitis. Therefore, patients with hyperlipidemia, especially those with obesity, should pay attention to physical exercise, a reasonable diet, control their weight and lower their blood lipids. If blood lipids cannot be controlled, medication should be used, preferably under the guidance of a specialist.

3. Drinking and overeating can also cause repeated attacks of acute pancreatitis. Patients with cholelithiasis and hyperlipidemia are more likely to develop acute pancreatitis. Moreover, the possibility of severe acute pancreatitis is greater. It is difficult for Chinese medicine to clear the interior, there is obvious intra-abdominal hypertension, and multiple organ dysfunction is also severe, which reduces the success rate of rescue. Therefore, patients who have a drinking habit and cholelithiasis should treat cholelithiasis early, reduce alcohol consumption, and avoid overeating. Prevention is very important.

4. Lesions around the duodenal papilla, such as inflammation, diverticula, polyps or early tumors, can only be detected through gastroscopy, barium meal and other examinations, and are easily missed in clinical diagnosis. Therefore, for patients with recurrent acute pancreatitis, if multiple ultrasound, CT or MRCP examinations fail to find the cause of recurrence, a gastrointestinal examination should be performed to confirm the diagnosis.

5. Anatomical abnormalities of the bile and pancreatic ducts can be congenital or acquired, such as bile and pancreatic duct stenosis, abnormal bile and pancreatic duct confluence, pancreatic divisum malformation, etc.

6. Other reasons: certain drugs, various infections, trauma, etc.

7. It is worth noting that idiopathic acute pancreatitis means that the cause has not yet been determined. I think that not finding the cause does not mean that there is no cause. This is related to the following factors: ① The doctor's reason. He did not look for the cause seriously, or did not think of looking for the cause, or when signals had already appeared, he did not carefully analyze and further examine them, and subjectively concluded that it was idiopathic; ② The conditions of the hospital, that is, the objective reasons. Some hospitals do not have the conditions to conduct relevant etiological examinations, or the equipment is outdated and has poor sensitivity; ③ The cause of the disease, such as when Ascaris lumbricoides are highly mobile and sneak into the bile and pancreatic ducts to cause acute pancreatitis, B-ultrasound examination was not performed in time. When the roundworms were examined again the next day, the roundworms had withdrawn and only pancreatitis changes were shown. For example, pancreatitis caused by bile sludge and micro-bile stones may not be easily found by B-ultrasound or CT examinations, but further ERCP examinations can reveal micro-bile stones by filtering and draining bile with gauze; ④ The cause of the patient. Most of them are due to insufficient knowledge, or misunderstanding of the doctor's advice, or financial difficulties, etc., and they are unwilling to accept relevant examinations. They have repeated attacks after discharge and are finally diagnosed after examination.