1. What is acute pancreatitis? Acute pancreatitis is a relatively common type of acute abdomen, and its incidence accounts for the 3rd to 5th place of acute abdomen. 80% of the patients are in mild condition, i.e. acute edematous pancreatitis, which can be cured non-surgically. More than 80% of the patients have mild disease, i.e., acute edematous pancreatitis, which can be cured by non-surgical treatment, basically it is a kind of internal disease. 10% of the patients belong to severe pancreatitis, i.e., acute hemorrhagic necrotizing pancreatitis, the inflammation of pancreas is not reversible or self-limiting, and it is often necessary to have surgical treatment, which should be regarded as a kind of surgical disease. Because of the deeper understanding of acute pancreatitis, diagnostic techniques and treatment methods have been developed, has become a surgeon is very interested in the problem, at the same time due to the death rate is still high, up to 30% to 60%. 2. What are the clinical manifestations of acute pancreatitis? (1) Abdominal pain: most of the acute pancreatitis is sudden onset, manifested as severe epigastric pain, and more radiating to the back of the shoulder, the patient consciously epigastric and lumbar back with a sense of “girdle”. (2) Nausea and vomiting: It occurs at the beginning of the disease and is characterized by the inability to relieve abdominal pain after vomiting. The frequency of vomiting is also consistent with the severity of the lesion. (3) Systemic symptoms: fever and jaundice may be present. The degree of fever is consistent with the severity of the lesion. A very small number of patients have a very rapid onset of symptoms, there may be no obvious symptoms or symptoms soon, that is, the occurrence of shock or death, known as sudden death type or sudden pancreatitis. 3. What are the common causes of acute pancreatitis? (1) Biliary system diseases; (2) alcohol or drugs; (3) infections; (4) hyperlipidemia and hypercalcemia; (5) surgical trauma or injuries. 4.How to diagnose acute pancreatitis? Combined with medical history, according to the CT of pancreas and blood and urine amylase abnormalities can be diagnosed. 5.What are the treatments for acute pancreatitis? The treatment of acute pancreatitis includes water fasting, gastrointestinal decompression, inhibiting the secretion of digestive juices, inhibiting pancreatic secretion, replenishing water and electrolytes, improving microcirculation, applying antibiotics, and if there is a peripancreatic abscess or necrotic infection, there is a possibility of surgical treatment. 6. What is the prognosis for acute pancreatitis? The morbidity and mortality rate of acute pancreatitis is about 10%, and almost all deaths occur in the first episode, accompanied by 3 or more of the Ranson indicators. The presence of respiratory insufficiency or hypocalcemia suggests a poor prognosis. Severe necrotizing pancreatitis has a case fatality rate of 50% or greater, which can be reduced to about 20% with surgical treatment. Three weeks or more after an attack of pancreatitis, the manifestation of persistent fever or hyperamylasemia suggests the presence of a pancreatic abscess or pseudocyst. 7.Complications of acute pancreatitis? Local complications (1) pancreatic abscess: refers to the encapsulated accumulation of pus around the pancreas, formed by necrosis and liquefaction of pancreatic tissue secondary to infection. It often appears after 2 to 3 weeks of disease onset, when the patient has high fever with symptoms of intoxication, abdominal pain worsens, an epigastric mass can be detected, and the white blood cell count is obviously elevated. The puncture fluid is purulent, and there is bacterial growth in culture. (2) Pancreatic pseudocyst: the fluid around the pancreas is not absorbed and is wrapped by fibrous tissue to form a pseudocyst. Most of the pseudocysts are formed 3 to 4 weeks after the onset of the disease. Physical examination often reveals an epigastric mass, and large cysts can compress the adjacent tissues and produce corresponding symptoms. Systemic complications (1) organ failure: one to multiple organ failure of varying degrees can occur, and in severe cases, multiple organ failure (MOF) is manifested. Mainly: ① circulatory failure, manifested as shock. ② Cardiac arrhythmia and heart failure. ③ Acute respiratory failure or acute respiratory distress syndrome, manifested by rapidly developing dyspnea and cyanosis, which cannot be relieved by conventional oxygen therapy. ④ Acute renal failure, manifested by oliguria, progressive elevation of blood urea nitrogen and creatinine. ⑤ Gastrointestinal bleeding, manifested by vomiting blood, black feces or bloody stools, and positive fecal occult blood test. (6) Disseminated intravascular coagulation. (7) Pancreatic encephalopathy, manifested by mental consciousness disorder or even coma. (2) Infection: the disease can be secondary to infections of the abdominal cavity, respiratory tract and urinary tract. The spread of infection can cause sepsis. In the later stage, due to the extremely low resistance of the body, coupled with the massive use of antibiotics, it is easy to have fungal infections. (3) A few may evolve into chronic pancreatitis. Prevention of acute pancreatitis Acute pancreatitis has a tendency to recur. Preventive measures include removing the causes and avoiding the triggers, such as abstaining from alcohol, not overeating, and treating hyperlipidemia. Cholelithiasis plays an important role in the development of acute pancreatitis, so cholelithiasis patients with a history of acute pancreatitis attacks should undergo elective cholecystectomy and choledochotomy. 9, acute pancreatitis diet in remission It is advisable to eat light and nutritious, fluid food, such as rice soup, vegetable soup, lotus root powder, egg soup, noodles, etc.; in addition to fluid food also includes rice porridge, vegetarian noodles, vegetarian noodles, vegetarian ravioli, bread, cookies (less oil) and a small amount of crushed soft vegetables, fruits and so on. When the abdominal pain, vomiting basically disappeared, leukocyte amylase reduced to normal can be given to the fat-free pure carbohydrate fluids, including: rice soup, thin lotus root powder, almond tea, fruit juice, jelly and other sugary foods. There is no stimulating effect on pancreatic exocrine secretion, so it can be used as the main heat supplement for acute pancreatitis. It is appropriate to increase the appropriate porridge, steamed egg white, a small amount of southern tofu soup food. Choose vegetable fats, more boiled, steamed, cold, burned, baked, brined, stewed and other ways of cooking. 10, acute pancreatitis to prevent recurrence of dietary taboos absolutely prohibit alcohol. Avoid eating greasy food. Avoid meat soup, fish soup, chicken soup, milk, egg yolk and other fat-containing foods. Avoid spicy and stimulating condiments, such as chili peppers, pepper powder, curry powder and so on.