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Abstract: The patient in this case was a 54-year-old male who came to the clinic with epigastric pain for more than six months. After routine examination and abdominal magnetic resonance, the patient was considered to have chronic pancreatitis caused by long-term alcohol consumption. The patient was given omeprazole sodium enteric soluble tablets for acid suppression and growth inhibitor for enzyme inhibition by injection as symptomatic treatment, while abstaining from food, and the patient was instructed to strictly abstain from alcohol.
Basic information】Male, 54 years old
Disease Type】Chronic pancreatitis
Hospital】Liaocheng People’s Hospital
Date of consultation】November 2021
Treatment plan】Medication (omeprazole sodium enteric solution tablets, growth inhibitor for injection, sodium chloride glucose injection)
【Treatment period】Inpatient treatment for 10 days, regular follow up
Effectiveness of treatment】Symptoms of epigastric pain disappeared, and normal life and work resumed
I. Initial consultation
The patient was a 54-year-old male who complained of epigastric pain for half a year, mainly in the upper abdomen and the left side of the pancreas, and was initially considered to have pancreatitis. The patient’s medical history showed that the patient had been drinking a lot of alcohol for a long time, and the routine blood tests and liver and kidney function were within the normal range, while the blood amylase was mildly elevated. The diagnosis of chronic pancreatitis was confirmed and the patient was admitted to the hospital for further treatment.
(Abdominal MRI)
II. Treatment history
Because chronic pancreatitis was found for the first time and was related to long-term heavy drinking, there were no pancreatic duct stones, pancreatic masses, pancreatic pseudocysts and other manifestations, and the early symptoms were mainly treated symptomatically. First of all, the patient was advised to strictly abstain from alcohol and fasting. At the same time, the patient was given symptomatic treatment with medications, including omeprazole sodium enteric dissolve tablets to assist acid suppression, growth inhibitor for injection to inhibit enzymes, and sodium chloride glucose injection for rehydration, etc. The patient was hospitalized for a total of 10 days, and after discharge, the patient was instructed to keep an eye on the changes of his condition and follow up regularly.
III. Treatment effect
After strict feeding and symptomatic treatment for about 5 days, the pain in the upper abdomen and left side of the patient’s body was significantly reduced, and he could start a liquid diet and gradually increase the amount of food he ate. After 10 days of hospitalization, the patient’s epigastric pain disappeared and the disease did not recur, so he was discharged and resumed normal life and work.
IV. Notes
We are glad that the patient’s pain symptoms disappeared after treatment, but the daily care after discharge is equally important. First of all, you should strictly abstain from alcohol, because this chronic pancreatitis is mainly related to long-term alcohol consumption, which leads to long-term inflammation of the pancreas, which in turn leads to incomplete obstruction of the pancreatic duct, resulting in dilatation of the pancreatic duct, leading to recurrent episodes of chronic pancreatitis. In terms of diet, pay attention to a light, easily digestible diet and avoid overeating. After discharge from the hospital, continue to take oral omeprazole sodium enteric tablets and other acid-suppressing drugs, and keep observing whether there are recurrent episodes of the disease. If epigastric pain occurs again, you should return to the hospital for a timely review, and if you find that the pancreatic duct stenosis is getting more and more severe or pancreatic duct stones, you may need endoscopic or surgical treatment.
V. Personal insight
Chronic pancreatitis is commonly associated with heavy alcohol consumption, but also in patients with unknown causes, which may be related to genetics, mutations, and autoimmunity. The early symptoms of the disease are mainly related to epigastric pain and discomfort, and the early stage of the disease should be strictly abstain from alcohol, avoid overeating, pay attention to the regularity of life and rest, and if the symptoms worsen, endoscopic or surgical treatment may be required. As in this case, chronic pancreatitis was caused by long-term alcohol consumption. After hospitalization, strict abstinence from alcohol was given and symptomatic treatment such as acid and enzyme suppression was given, and symptoms were significantly relieved. However, patients should strictly abstain from alcohol in the future, and if they drink again, it may lead to recurrence or even aggravation of the disease.