June 24, 2022

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The Death rate of pancreatitis can reach 50% if ignoring 5 symptoms

The Death rate of pancreatitis can reach 50% if ignoring 5 symptoms

 

The Death rate of pancreatitis can reach 50% if ignoring 5 symptoms.   The fatality rate can reach 50%: once there are 5 symptoms, it is likely to be pancreatitis, don’t ignore it!


In a small number of patients, pancreatin or necrotic tissue fluid leaked into the abdominal wall along the retroperitoneal space, causing the skin on both sides of the waist to appear dark grayish blue, called Grey-Turner sign, or the skin around the umbilical blue, called Cullen sign.


For example, a male patient began to suffer from abdominal pain at 8 o’clock in the morning, accompanied by nausea and vomiting. At first, this patient thought it was a gastric attack, so he took stomach medicine at home by himself, but the symptoms did not alleviate. Instead, he gradually turned to total abdominal pain accompanied by cold sweats, and the pain aggravated, so he had to be taken to the hospital by his family.

After careful inquiry, the doctor learned that this patient had a rare dinner with his old classmates on weekends the previous day. He drank freely and drank more than two catties of white wine. The doctor immediately put this patient to rest in bed. Finally, after blood tests, abdominal CT and other examinations, this patient was diagnosed with acute pancreatitis.

 

 

Understanding acute pancreatitis:

Acute pancreatitis refers to an inflammatory reaction in which pancreatic enzymes are activated in the pancreas due to a variety of etiologies, causing the pancreatic tissue to digest itself, leading to edema, bleeding and even necrosis. There are many causes of acute pancreatitis, biliary diseases and heavy drinking are common causes.


1. Cholelithiasis and Biliary Tract Diseases

Cholelithiasis, biliary tract infections, and biliary roundworms are the main causes of acute pancreatitis, accounting for more than 50%.

Gallstones, infections, roundworms, etc. cause edema and spasm of Oddi’s sphincter, causing duodenal juice or bile to flow back into the pancreatic duct, causing acute pancreatitis.

 

2. Alcoholism and binge eating

Excessive drinking and overeating can cause increased pancreatic juice secretion, and stimulate Oddi sphincter spasm, obstruct the drainage of pancreatic juice, increase pancreatic duct pressure, and cause acute pancreatitis.



3. Pancreatic duct obstruction

For example, pancreatic duct stones, pancreatic duct stenosis, tumors or ascaris burrowing into the pancreatic duct can cause pancreatic duct obstruction. When pancreatic juice is secreted vigorously, the pressure in the pancreatic duct increases, causing the small branches of the pancreatic duct and the pancreatic vesicles to rupture, and the infiltration of pancreatic juice and digestive enzyme Qualitatively cause acute pancreatitis.



4. Surgery and trauma

Abdominal surgery, especially pancreaticobiliary or stomach surgery, blunt abdominal contusion, etc. can directly or indirectly damage the pancreatic tissue and the blood supply of the pancreas and cause pancreatitis.

 

5. Endocrine and metabolic disorders

Hypercalcemia or hyperlipidemia caused by any cause can cause pancreatitis through pancreatic duct calcification or lipid deposition in pancreatic juice.


6. Infection

Certain acute infectious diseases, such as mumps, infectious mononucleosis, etc., can increase pancreatic juice secretion and cause acute pancreatitis, but the symptoms are mostly mild and resolve spontaneously as the infection recovers.


7. Drugs

Certain drugs, such as thiazide diuretics, glucocorticoids, tetracyclines, sulfonamides, etc., can directly damage pancreatic tissue, increase pancreatic juice secretion or viscosity, and cause acute pancreatitis.

 

8. Other

Retroduodenal penetrating ulcer, duodenal diverticulitis adjacent to the nipple, transfusion loop syndrome after gastric surgery, kidney or heart transplantation
It can also cause acute pancreatitis, which is rare in clinical practice.

 

 


5 major symptoms of acute pancreatitis:

01. Abdominal pain

The pain is severe and continuous, presenting dull pain, drilling pain, colic or knife-cutting pain, and may be exacerbated by paroxysmal. Abdominal pain is often located in the upper left abdomen and radiates to the waist and back. The pain can be relieved by bending the waist and holding the knees. Generally, gastrointestinal antispasmodics are ineffective.


The mechanisms that occur include:

①Inflammatory stimulation and pulling of nerve endings on the pancreas capsule;

②The extravasation of inflammatory exudate and pancreatic juice stimulates the peritoneum and retroperitoneal tissues;

③Inflammation affects the intestines, causing flatulence and intestinal paralysis;

④ Pancreatic duct obstruction or cholecystitis, cholelithiasis
Cause pain.

 

 


02. Nausea, vomiting and abdominal distension

Nausea and vomiting often occur after the onset of the disease, sometimes quite frequently. The vomit is the contents of the stomach.
In severe cases, bile or even blood may be mixed, and there will be no comfort after vomiting. Often accompanied by
Abdominal distension, even paralytic intestinal obstruction.


03. Fever

Most patients have moderate or higher fever, which usually lasts for 3 to 5 days. If fever persists for more than 1 week with elevated white blood cells, secondary infections such as pancreatic abscess or biliary tract inflammation should be considered.

 

04. Hypotension or shock

Severe pancreatitis often occurs, patients are irritable, pale, clammy, etc.; a very small number of patients may suddenly experience shock or even sudden death. The main reasons are insufficient effective circulating blood volume, pancreatic necrosis and release of myocardial inhibitory factors to cause myocardial dysconstriction, complicated infections and gastrointestinal bleeding.


05. Disorders of water, electrolyte and acid-base balance

Dehydration of varying severity, frequent vomiting may have metabolic alkalosis. Severe patients may have significant dehydration and metabolic acidosis, accompanied by decreased blood potassium, blood magnesium, and blood calcium, and some may have increased blood sugar, and occasionally diabetic ketoacidosis or hyperosmolar coma may occur.

 


Tips:

In a small number of patients, pancreatin or necrotic tissue fluid leaked into the abdominal wall along the retroperitoneal space, resulting in dark grayish blue skin on both sides of the waist, called Grey-Turner sign, or skin bruising around the umbilical, called Cullen sign.

 

 

(source:internet, reference only)


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