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Abstract: The patient presented to our hospital with persistent epigastric pain accompanied by repeated nausea and vomiting, which did not improve after self-medication. I found that the patient was suffering from pancreatitis (acute pancreatitis) through physical examination combined with laboratory tests and abdominal CT examination, and treated him with fasting, anti-inflammatory, analgesic and suppression of pancreatic and gastric acid secretion. After 1 week of hospitalization, the patient’s condition improved and the abdominal pain, nausea and vomiting disappeared, and she was discharged.
Basic information】Female, 23 years old
Disease Type】Pancreatitis (acute pancreatitis)
Hospital】The First Hospital of China Medical University
Time of consultation】April 2018
【Treatment plan】Intravenous injection (cefoperazone sodium tazobactam sodium for injection, growth inhibitor for injection, cimetidine injection, pethidine hydrochloride injection, sodium chloride glucose injection)
[Treatment period] Hospitalization for 1 week
Treatment effect] Abdominal pain, nausea and vomiting disappeared, and all indicators improved
I. Initial consultation
The patient, a 23-year-old female, came to our hospital with persistent epigastric pain. She reported sudden and persistent epigastric pain with paroxysmal aggravation, accompanied by repeated nausea and vomiting, and the vomit was stomach contents. He had been treated with Pyridoxine tablets, Sanjiu Gastrodia capsules and Gastroenterology tablets, but the effect was relatively poor, so he came to our hospital for further treatment. The patient was found to have fever of 37.6℃, flat abdomen, pressure pain and rebound pain in the left upper abdomen and mid-upper abdomen, elevated serum amylase in laboratory tests, and acute pancreatitis in abdominal CT examination.
II. Treatment
After admission, I told the patient not to worry too much because the symptoms were not serious and could be cured by 1 week of fasting, anti-inflammatory, pain relief, and treatment to suppress pancreatic and gastric acid secretion. After obtaining the patient’s consent, I actively carried out treatment and gave the patient cefoperazone sodium tazobactam sodium injection for anti-inflammatory treatment, growth inhibitor injection to suppress pancreatic secretion, cimetidine injection to suppress gastric acid secretion, pethidine hydrochloride injection for pain relief, and sodium chloride glucose injection for parenteral nutrition support. After 1 week of the above treatment, the patient was discharged home for recuperation.
III. Treatment effect
The patient was admitted to the hospital for 1 day for persistent abdominal pain, nausea and vomiting, and the above symptoms were significantly reduced. After 1 week of fasting, anti-inflammatory, pain-relieving and pancreatic and gastric acid suppressing treatment, the patient’s abdominal pain, nausea and vomiting disappeared completely, and he felt well and requested to be discharged. I found that the patient’s body temperature had returned to normal, the pressure pain and rebound pain in the left upper abdomen and middle and upper abdomen had disappeared, and the routine blood test showed that the indicators such as white blood cells had improved, so the patient was discharged.
IV. Precautions
I was very happy that the patient’s discomfort disappeared and he could be discharged from the hospital for recuperation. At the same time, in order to help the patient recover better and avoid another attack of pancreatitis, we need to remind the patient to pay attention to the following points.
1. After discharge from the hospital, patients should pay attention to the change of diet from liquid or semi-liquid to solid food, and avoid eating hard food too early to avoid stimulating excessive secretion of pancreatic juice, which may lead to abdominal pain and other symptoms again.
2, daily drink more warm water, eat less cakes, fried chicken and other high-fat food, and need to avoid overeating, so as not to lead to hyperlipidemic pancreatitis.
3. Patients also need to exercise properly during recuperation at home, such as jogging and playing badminton, to enhance the body’s resistance to disease and help control weight to reduce the chance of pancreatitis occurring again.
V. Personal insights
In the clinic, we see more patients who come to the doctor because of acute pancreatitis. Most of them suffer from gallstone disease, excessive alcohol consumption or hyperlipidemia, which leads to acute pancreatitis attacks and symptoms such as abdominal pain, nausea and vomiting. Some patients who have such symptoms do not seek medical attention for fear of trouble or excessive costs, but use their own medication. However, most patients have difficulty in determining what disease they are suffering from, as in the case of the patient in this case, who mistakenly thought he was suffering from stomach problems and came to the hospital after taking medication that did not improve. Fortunately, the patient’s symptoms were relatively mild and healed after medication, but some patients have severe symptoms due to delayed treatment, and even require surgery.