Beware of acute pancreatitis

  Acute pancreatitis is a systemic inflammatory disease based on acute local inflammation of the pancreas, which may lead to functional and organic damage to other organs or systems of the body, and is one of the common surgical emergencies. 80% of patients have pancreatic edema as the main local pathological change, and the systemic inflammatory response is mild, with a smooth clinical course and good prognosis, called acute edematous pancreatitis. In 20% of patients, pancreatic necrosis is the main local pathological change, and the systemic inflammatory response is intense, leading to important organs and local complications, with a dangerous clinical course, called acute hemorrhagic necrotizing pancreatitis, with a high mortality rate. The main cause of patient death in the early stages of the disease is respiratory failure, while later deaths are mainly related to infection.  The most common clinical risk factors for the disease are: 1. Biliary stones and alcoholism, which constitute 70-80% of the cause. In China, cholelithiasis is the first causative factor, followed by alcoholism; 2. 10-20% of patients are associated with pancreatic duct stenosis, infection, surgery, hyperlipidemia, hypercalcemia, drugs, trauma, pancreatic circulation disorders and invasive tests such as retrograde cholangiopancreatography (ERCP); 3. 5-10% of patients have an unknown cause, also known as idiopathic pancreatitis.  Clinical manifestations: 1, abdominal pain: the main symptom of the disease, often occurs suddenly after a full meal or alcohol consumption, pain is intense, mostly located in the upper abdomen, radiating to the lower back. Biliary origin begins in the right upper abdomen, the center of pain gradually moved to the upper abdomen; 2, abdominal distension: the heavier the inflammation, the more obvious abdominal distension; 3, gastrointestinal symptoms: such as nausea, vomiting often accompanied by abdominal pain, vomiting abdominal pain symptoms can not be relieved, vomit for the stomach and duodenal contents; 4, biliary pancreatitis with biliary tract infection often have chills and fever, with biliary obstruction with jaundice, severe cases soon after the onset of the disease can occur in severe cases, such as shock.  Diagnosis: Serum amylase, urinary amylase, blood routine, ultrasound examination and other examination results can make a preliminary diagnosis, and CT examination of the upper abdomen can clarify the diagnosis of acute pancreatitis. In addition, CT examination results combined with the severity of various clinical manifestations at the onset, the degree and speed of progression, as well as blood biochemical examination indexes can predict light or heavy pancreatitis, which is a good guide for the regression of the disease and the formulation of treatment plans.  Prevention: Chinese New Year is the most traditional and grandest festival for Chinese people. According to Chinese customs and food culture, the period around Chinese New Year will be celebrated with frequent gatherings and interpersonal exchanges. Therefore, the general public is reminded not to overeat, and patients with biliary stones and a history of previous biliary tract infections should be especially vigilant to avoid trouble for body, mind and family. When pancreatitis is suspected to occur, please seek medical attention in a timely manner to avoid delays and life-threatening conditions.