Symptoms and treatment of acute pancreatitis in adults

The pancreas is an internal organ that plays an important role in the human body. Its endocrine function is to develop normalizing blood sugar levels of the hormone insulin, glucagon and lipokoina, exocrine - in the allocation of pancreatic juice involved in the process of digestion in the duodenum.

difficulty of outflow latter causes a number of disorders that lead to digest the gland itself and, as a consequence, to the rapid development of the inflammatory process of the body - acute pancreatitis, which occurs not only in adults but also in children.

According to statistics, 85% of all cases of the disease gives a positive effect in timely comprehensive conservative therapy, which are components of medication and a strict diet long-term.

Surgical treatment of acute pancreatitis is performed according to vital indications in patients with development of purulent-destructive complications.

The overall mortality in adults and small patients is 9-12%.

Types of acute pancreatitis

Over the past two decades, inflammation of the pancreas continues to occupy third place in frequency among cases of acute diseases of internal organs of the abdominal cavity surgical in children and adults. There are several forms of acute pancreatitis, including:

• Ipterstial, in which there is a strong swelling of the organ itself;
• hemorrhagic, accompanied by a hemorrhage in the gland tissue;
• purulent pancreatitis, characterized by the presence of foci of purulent fusion in the injured organ;
• acute pancreatic necrosis, in which foci of decomposition appear on the compacted organ;
• choleciotopancreatitis in acute form, combining acute inflammation of the pancreas and gallbladder.

reasons

Among the main etiological factors of acute and acute exacerbations of chronic pancreatic inflammation in adults should be made:

1. Alcohol;
2. Gallstones;Injuries to the pancreas.

provoke it can also :

• diseases of the digestive organs;
• parasitic infestations;
• operations performed on the bile duct and stomach;
• certain pharmacological preparations;
• exacerbation of infectious, viral, vascular diseases;
• pathology of the pancreatic duct;
• hormonal failures.

Approximately in every third case, the cause of acute pancreatitis in adult patients can not be established.

As for this disease in children, almost everyone, both infectious and allergic, can lead to pancreatitis. This is due to the fact that their reaction to external effects on the body is much more acute than in adults.

Symptoms of

The main sign of acute inflammation of the pancreas, both in children and in adults, is severe shingling pain in the epigastric region, right and left hypochondrium, which increases with movement. In this regard, the patient has a feeling, as if his body is tightly tied with a belt.

In the case of an exacerbation of pancreatitis, symptoms such as:

1. Hiccups, dry mouth, belching;
2. Nausea leading to episodic vomiting;
3. Increased body temperature;
4. Paleness of skin;
5. Bloating;
6. Plentiful sweating;
7. Weakness, dizziness, loss of appetite;Disturbance of stool, flatulence.

These symptoms suggest immediate medical attention for further examination, diagnosis and appropriate therapy. In severe disease, the patient may drop blood pressure and there is a shock, which can become a life threat.

Diagnosis of acute inflammation of the pancreas

Despite the symptoms indicating the presence of an exacerbation of disease, to confirm the diagnosis of acute pancreatitis in the early stages is necessary to conduct the following laboratory and instrumental methods of diagnosis, conducted usually in a hospital:

• general analysisBlood, which helps to detect symptoms of exacerbation of the inflammatory process;
• blood sugar analysis showing elevated blood glucose;
• biochemical analyzes of urine and blood, which, with an increase in the level of amylase, confirm the presence of the disease;
• a coprogram that identifies uncooked muscle fibers of meat products and fats;
• ultrasound and chest radiograph of the abdominal organs, allowing to detect changes in the gallbladder and pancreas;
• CT and MRI, which make it possible to see the injured organ in different planes on thin "slices";
• gastroscopy, which determines the degree of involvement in the inflammatory process of the duodenum and stomach;
• ERHPG, allowing to assess the patency of the bile ducts and ducts of the pancreas;
• functional tests.

Conservative therapy

treat this dangerous disease is fraught with serious complications, it is necessary in the hospital. Conservative treatment of acute pancreatitis relates to mild basic methods of disease treatment, the main principles of which are:

1. Drug elimination of pain and shock prevention. It is usually performed using non-narcotic drugs( aspirin, diclofenac, octreotide) and narcotic drugs( morphine).
2. Purification of blood from the released aggressive enzymes of the pancreas. The procedure is performed using infusion therapy, which is an intravenous infusion of a large volume of special solutions. Such drugs as gordoks, trasilol, contrycal, pantripina, zimofen, ingitril, iniprol, tsalol other, diluted blood, and thereby reduce the concentration of enzymes produced by the pancreas.
3. Symptomatic treatment. Pharmacological preparations help to remove such symptoms and conditions as repeated vomiting, cardiovascular insufficiency, and a decrease in the calcium index in the blood.
4. Strict diet. Its compliance with acute pancreatitis or in the case of chronic exacerbation is aimed at providing the inflamed pancreas with maximum rest. In the first days the patient is given a hunger diet, at which only drinking water is allowed. With the help of special nutrient solutions, parenteral nutrition is produced, which after 3-7 days can be replaced by enteral intake of a small amount of liquid food. In the future, the patient is assigned a diet № 5П( I variant) and diet № 5П( ІІ variant).
5. Reception of antibiotics, which are prescribed strictly individually, both to treat existing infections, and to prevent infection of injured organs.

good ability to penetrate into tissue of the pancreas possess drugs such as:

• cephalosporins IV( cefepime) and III( cefoperazone, cefotaxime, ceftazidime, ceftriaxone) generations;
• piperacillin;
• carbapines( meronem, thienes);
• Metronidazole.

Operative treatment

In the case of the development of severe acute pancreatitis, in the early days, the question of the operation may become. It is necessary when symptoms increase, infections develop, as well as in pancreatitis, which is a consequence of trauma or caused by gallstones. After the operation, the patient should be individually treated, which can be arranged only in the intensive care unit.

Postoperative treatment is:

1. Timely removal of the pain syndrome;
2. Systematic control of all parameters of pressure, blood, urine;
3. Fighting infection and metabolic disorders.

From the medications at this time introduce:

• promedol, dimedrol, antispastic drugs, alternating them with vascular and cardiac agents;
• antibiotics in the composition of the injected fluid, consisting of vitamins, glucose and protein preparations.

After a medical starvation the patient is gradually transferred to a special diet: first, a sparing pancreatic diet No. 5P( I) is prescribed, which is then replaced with diet II.Before discharge from the hospital, patients are advised not to smoke, not to take alcoholic beverages and not to eat fatty foods for the complete restoration of the pancreas.

Prevention

As the primary prevention of the disease is the prevention of the development of its chronic form, which includes a full course of quality therapy for acute pancreatitis in the hospital. Many patients, feeling better, stop medication, although the inflammation persists for a long enough period, despite the absence of clinical symptoms, and, if left untreated, it can go into an incurable chronic form accompanied by constant exacerbations and various complications.

Secondary prophylaxis of acute pancreatitis combines components such as:

• complete rejection of any alcohol;
• lifelong diet;
• timely treatment of various chronic infections, including caries, sinusitis, otitis, cholecystitis and others;
• exclusion of drugs that can cause damage to the pancreas.

Careful implementation of the above conditions will ensure the successful and effective disposal of such a formidable disease as acute pancreatitis.

Useful video about acute pancreatitis