Diagnosis and treatment of acute pancreatitis
Pathogenesis of acute pancreatitis acute course with rapid and high mortality. Clinically often due to acute pancreatitis were divided into edematous and hemorrhagic necrosis of type two broad categories, usually manifested in patients with upper abdominal pain, back pain, to the Ministry of diffuse, abdominal distension, nausea, vomiting, jaundice, severe difficulty in breathing or shock can occur . Biliary tract disease, alcohol consumption, high-fat diet is a common trigger of acute pancreatitis.
Diagnosis: B super-good or better CT of severe acute pancreatitis addition to checking the blood and urine amylase, doctors are often in patients with B-ultrasound. B-ultrasonic examination can be found pancreatic enlargement, pancreatic duct expansion, ascites, etc., but because of the plot in patients with intestinal gas or obesity, can B-test results are inaccurate or difficult to observe. The CT can provide an objective picture of the pancreatic swelling was observed around necrotic exudate and their own situation, as well as the formation of abscess or cyst size. CT can be reviewed on a regular basis to determine the recovery of pancreatitis. Therefore, we propose that patients with severe acute pancreatitis with pancreatic conventional CT.
Feeding: Choosing the right time for fasting is the most important of acute pancreatitis treatment measures. However, many patients with cancer under control, restore, after eating, but also abdominal pain, so that they are afraid to eat. When eating in patients with a doctor and have been exploring the issue. The past, patients have to wait until pain disappeared, blood and urine amylase returned to normal before we start into the liquid diet, such as rice porridge, no rape soup. Can be found in many patients, the clinical symptoms and signs disappeared, but the blood and urine amylase was still higher than normal, and even a few months before returning to normal. Such patients should be allowed into the liquid diet, but should be closely observed, if they feel unwell at any time to the hospital.
Surgery: strict control of indications of acute edematous pancreatitis, we used fasting, anti-inflammatory, inhibit pancreatic secretion and so can the success of conservative treatment. The acute hemorrhagic necrotizing pancreatitis required to take "individual" treatment, that is, the different circumstances of each patient to choose different treatment programs. If cancers are due to acute pancreatitis caused by biliary tract disease, often called gallstone pancreatitis, We stand for active surgical treatment; if does not exist in patients with biliary tract disease, we advocate conservative treatment first, such as fasting, gastrointestinal decompression, anti-inflammatory, inhibit pancreatic secretion, intravenous nutrition. In this process, such as the patient's condition is still constantly increasing, there body temperature is higher than 38 ℃, WBC more than 20000 / m m3, abdominal puncture fluid found in bacteria, should be taken to surgery. The late disease in patients with pancreatic abscess or pancreatic pseudocyst, also need surgery.
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