Acute pancreatitis is an inflammation of the pancreas. The symptoms of pathology primarily include intolerable acute pain in the abdomen. The localization of pain will depend on which part of the gland is inflamed. So, the pain can be localized in the epigastric region, in the left or right hypochondrium.
There are options when the pain is girdling. Chronic pancreatitis is accompanied by symptoms such as loss of appetite, indigestion, acute pain that occurs after drinking alcohol, spicy or fatty foods.
In this article, we consider the complications of acute pancreatitis.
Description of the disease
Pancreatitis is a disease that is characterized by the onset and development of inflammatory processes affecting pancreatic tissue. Pancreatitis can be classified by the nature of its course into chronic and acute. In this acute pancreatitis is the third in the ranking of the most common diseases of the abdominal organs requiring treatment in a hospital. In the first and second places, respectively, are acute appendicitis and acute cholecystitis. Complications of acute pancreatitis can be very serious.
Statistical data
World statistics show that every year up to 800 people out of a million get sick with an ailment such as acute pancreatitis. Men with this type of pancreatitis are sick much more often than women. The age of patients has a fairly wide range, and this is directly related to the reasons why acute pancreatitis arose. If acute pancreatitis arose and developed against the background of excessive drinking, then the average age of patients is 39 years. If the cause of this disease was cholelithiasis, the average age of patients is at around 69 years old.
The pathogenesis and etiology of acute pancreatitis
A variety of factors can contribute to the occurrence of a disease such as acute pancreatitis. Among them:
- Cholelithiasis.
- Bad eating habits.
- Alcohol abuse.
- Viral infections, such as the Coxsackie virus.
- Bacterial infection, for example, campylobacter or mycoplasma.
- Pancreatic injury.
- Taking drugs that contain estrogens, corticosteroids, thiazide diuretics, azathioprine. That is, those drugs that have a pathological effect on the pancreas. Such pancreatitis is medication.
- Surgical interventions that were aimed at treating other diseases of the pancreas and biliary tract.
- Cystic fibrosis.
- Genetic predisposition.
- Congenital anomaly that affected the development of the pancreas.
- Gastrointestinal diseases of an inflammatory nature, including cholecystitis, gastroduodenitis, hepatitis.
Complications of acute pancreatitis can be prevented if pathology is detected in a timely manner.
Provocative factor
In accordance with the most common theory about the causes of pancreatitis, the main factor provoking the development of this disease is cell damage, which is caused by enzymes that are prematurely activated. If the conditions are normal, then the pancreas produces enzymes involved in digestion in a reactive state. Their activation occurs directly in the digestive tract. In the event that there are internal pathological factors or external factors influence, the activation of enzymes occurs inopportune, in the tissues of the pancreas. The consequence of this is the digestion of the tissues of the pancreas itself. As a result, an inflammatory process occurs , swelling of the tissues develops, damage to the vessels of the gland parenchyma occurs. The history of the disease (acute pancreatitis) is known to all specialists.
If pancreatitis is acute, then a similar pathological process can affect tissues located in the immediate vicinity of the gland itself, for example, retroperitoneal tissue, omental bursa, peritoneum, omentum, mesentery of the intestine, and ligaments of the liver can be affected. If acute pancreatitis occurs in a severe form, then the level of various biologically active substances in the blood rises sharply. This leads to severe disturbances in the functioning of the body. Secondary inflammatory processes, dystrophic disorders of various organs and tissues, for example, heart, kidneys, lungs, liver, can occur.
These manifestations are complications of acute pancreatitis.
Disease classification
Acute pancreatitis can be classified according to the severity of its course:
- Mild pancreatitis causes minimal damage to tissues and organs. It is expressed mainly by interstitial edema of the pancreas itself. Therapy lends itself quite easily, the prognosis is very favorable, implying a quick and complete recovery.
- Acute pancreatitis, which occurs in severe form, causes significant and severe disorders of tissues and organs. Local complications are also characteristic of it, which include tissue necrosis, infection, abscesses, cysts.
Severe severe liver failure may accompany:
- Acute accumulation of fluid in the tissues of the gland or in the periopancreatic space that does not have granulation or fibrous walls.
- An acute false cyst, which is an accumulation of pancreatic juice, which is surrounded by a fibrous wall or granulations and resulting from an attack of the disease. The development of such a cyst occurs within four to six weeks.
- Pancreatic abscess, which is an accumulation of pus in the tissues of the pancreas and tissues that are in close proximity to it.
- Pancreatic necrosis, leading to tissue infection. There is a spilled or limited area of ββthe parenchyma, which begins to die. If infection joins and purulent pancreatitis begins to develop, the probability of a fatal outcome increases significantly.
Below we will tell about the history of the disease in acute pancreatitis in more detail.
Symptomatology
The characteristic symptoms of acute pancreatitis include:
- Pain syndrome. Pain can have an epigastric localization, can be observed in the left hypochondrium, have a shingles, possibly radiating under the left shoulder blade. Pain in acute pancreatitis is pronounced, are permanent. If the patient is lying supine, the pain is greatly increased. The pain also intensifies after eating spicy, oily or fried foods, after drinking alcohol.
- Sensation of nausea, vomiting. In this case, vomiting is most often indomitable, contains a large amount of bile, does not bring relief.
- Heat.
- Yellowness sclera. It is most often expressed moderately. In rare cases, manifestation of jaundice on the skin is possible.
In addition, acute pancreatitis can accompany dyspeptic symptoms. These include flatulence, bloating, heartburn. Manifestations on the skin, for example, hemorrhages located in the navel, spots on the body having a bluish color are not excluded.
How is acute liver failure detected in a person?
Diagnosis of the disease
Gastroenterologists carry out the procedure for the diagnosis of pancreatitis, based on the patient's complaints and physical examination. The latter allows you to identify specific symptoms.
What tests do you have for pancreatitis?
During the procedure for measuring pulse and blood pressure, tachycardia and hypotension are detected. To confirm the diagnosis, various laboratory tests of urine and blood, ultrasound of organs located in the abdominal cavity, MSCT, and pancreatic MRI are performed.
In the case of acute edematous pancreatitis during a blood test, a general analysis shows signs of an inflammatory process (ESR accelerates, white blood cell count rises). Biochemical analysis reveals an increased activity of pancreatic type enzymes (lipases and amylases). Hypocalcemia and hyperglycemia are not excluded. In addition, the concentration of enzyme compounds in the patient's urine should be determined. Possible manifestations of bilirubinemia, increased activity of liver enzymes.
Urine biochemistry allows the determination of amylase activity in urine.
It is necessary to conduct a visual examination of the pancreas, as well as organs in the immediate vicinity. A similar study is carried out by CT, ultrasound, MRI. It allows you to detect a pathological change in parenchyma, cysts, abscesses, stones in the ducts, an enlarged gland.
Treatment
If acute pancreatitis is detected, the patient is shown hospitalization with subsequent bed rest. The main goal of treatment is to eliminate the pain syndrome, stimulate self-healing processes, reduce the load that rests on the pancreas.
The treatment with therapeutic methods include:
- novocaine and antispasmodic blockade, the main purpose of which is the removal of too severe pain syndrome;
- the use of pancreatic enzyme deactivators (proteolysis inhibitors);
- carrying out detoxification therapy;
- the use of antibiotic therapy to prevent infectious complications; most commonly used drugs that have a wide spectrum of action, but in large dosages;
- fasting, applying ice to the area of ββthe gland in order to create local hyperthermia.
Surgical treatment is prescribed in the following cases:
- if there are stones in the bile ducts ;
- accumulation of fluid around or in the gland;
- the occurrence of cysts, necrosis, abscesses.
In acute pancreatitis, endoscopic drainage, cystogastrostomy, and cyst marsupialization may be indicated. If necrosis has formed, then depending on its size, the doctor may prescribe a necrectomy or an operation to resect the pancreas. Stones can cause duct surgery.
Possible complications
Acute pancreatitis is dangerous for its possible consequences and complications. If infection of tissue that is inflamed occurs, then the occurrence of necrosis and abscesses is not ruled out. If you do not conduct timely treatment, then a fatal outcome is possible.
If the ailment proceeds in severe form, the development of a shock state with pancreatitis and multiple organ failure is possible.
The result of the development of acute pancreatitis can be the formation of pseudocysts, the rupture of which is fraught with the onset of ascites.
Pancreatitis diet: weekly menu
With an exacerbation of pancreatitis in the first day or two, you need to follow a starvation diet, two glasses of rosehip decoction are allowed, up to 1 liter of alkaline mineral water. In severe cases, nutrition is only drip intravenously.
With pancreatitis, diet No. 5p is shown, which consists of several options.
Below is a sample menu for a week with pancreatic pancreatitis.
- For breakfast, you can eat meat (chicken or beef), steamed. They drink a rosehip broth or weak tea.
- For breakfast, oatmeal with milk is served, washed down with a decoction or infusion of rose hips.
- For lunch - mashed carrot and potato soup. You can eat steamed fish. Dried fruits compote.
- For afternoon tea - fruit puree (apple or pear).
- Dinner should include a piece of boiled chicken, vegetable stews and weak tea.
- Before going to bed, drink a glass of kefir.