Thursday, December 13, 2012

Acute Pancreatitis, terrible consequence


Acute Pancreatitis, terrible consequence ...
Acute pancreatitis is a condition resulting from acute inflammation of the pancreas. The main function of the pancreas is to produce digestive enzymes, insulin and glucagon to regulate blood sugar levels.

In pancreatitis, pancreatic enzymes that are normally released in the small intestine to aid in digestion are activated inside the pancreas and start to damage it. If the crisis is severe or prolonged, or if outbreaks of acute pancreatitis occur repeatedly, permanent damage to the pancreas may occur and lead to a condition called chronic pancreatitis.

The two most common causes of pancreatitis are gallstones and bile alcoholism (alcohol abuse). Since the pancreatic duct, which carries digestive enzymes from the pancreas into the small intestine is common to the bile duct, which has gallbladder and liver, gall stones which prevents clogging the canal pancreatic enzymes from reaching the intestine, being accumulated within liver and since being activated, eroding the body inside. Although most people who drink alcohol do not develop pancreatitis, drinking large amounts of alcohol can turn pancreatitis.

Other factors that can sometimes cause pancreatitis include:

Abdominal trauma (traumatic pancreatitis)
Abdominal surgery, drugs, including certain antibiotics (metronidazole, tetracycline and sulfa), thiazide diuretics and estrogen, calcium or High levels of triglycerides in the blood, Some infections, such as mumps or viral hepatitis,
Endoscopic procedures involving pancreatic and bile duct,
Idiopathic (no cause is found).

Symptoms

Symptoms of acute pancreatitis includes:

a Upper abdominal pain which may be tolerable to the piercing in range at the time of the stomach, both right and left;

Projection of the pain to the back, chest, flank or down

Worsening of the pain with food, especially fatty

the nausea and vomiting,

o Loss of appetite

the Abdominal distention (swelling),

The Fever,

o Lack of air

Fatigue,

the hypotension and shock (very low pressure disabling the functioning of organs).


Diagnosis

The patient's medical history will reveal the abuse of alcohol which, when absent, especially in women, is strongly suggestive of gallbladder calculi, confirmed by ultrasound examination.

Blood tests reveal elevated levels of pancreatic enzymes, amylase and lipase confirming the diagnosis of pancreatitis. The decrease in blood calcium signal is worsened, as well as the increase of leukocytes, glucose, urea and creatinine.

In some cases of pancreatitis the blood amylase may be normal as it rises rapidly at first and then decreases, signifying no improvement.

In some cases, a CT scan of abdomen when there is suspicion of swelling of the pancreas and the presence of fluid in the abdomen. A CT scan can also reveal pancreatic pseudocysts that are cavities containing pancreatic enzymes that develop in some cases of severe pancreatitis in chronic pancreatitis. Serious complications can occur when the cysts burst and the enzymes come in contact with the surface of the abdomen (peritonitis).

Prevention

Avoid the abuse of alcohol if the person never had pancreatitis,

Never drink the most, if the person has had an episode of alcohol-induced pancreatitis,

it is believed to maintain a normal body weight and to prevent rapid weight loss may prevent the development of gallstones,

Avoid the indiscriminate use of antibiotics and oral contraceptives-based estrogen.



Treatment


· General Measures:



Rest in hospital

Fasting to "rest" the pancreas,

the replacement fluid intravenously

the passage of a catheter through the nose into the stomach to control the vomiting,

The parenteral nutrition (for a vein thick) may be required in more severe cases,



· Medications to protect stomach ulcers from stress. Includes H2 blockers (ranitidine hydrochloride) and proton pump inhibitors (omeprazole, pantoprazole, esomeprazole, etc.)



· Antibiotics are indicated only in severe cases and when the cause is gallstones by the frequent presence of infection of the gallbladder - cholecystitis.



· Surgery is indicated in the following situations:



the definitive treatment of gallstones (cholecystectomy)

Infection with the documented pancreatic abscess (collection of pus)

The Necrosis (deterioration) wide pancreas,

The major bleeding,

Shock that does not improve

the failure of multiple organs.

Call your doctor?

The patient with severe abdominal pain that does not improve with home measures, or is accompanied by intense vomiting or nausea, you should look for a surgeon general or be treated at an emergency room.

Prognosis.

Pancreatitis often mild improvement in the first week without complications and without any additional problems, but severe cases can last several weeks. Chronic pancreatitis may develop if there is a significant lesion of the pancreas or if the patient had several attacks over time.

Nearly 10 percent of patients develop complications such as abscesses and necrosis of the pancreas that may require surgical treatment.

The pancreatitis caused by alcohol in crises occur from time to time, if the patient insists on drinking. Approximately 10 percent of patients with acute pancreatitis develop alcohol-related chronic pancreatitis.

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