Causes of severe acute pancreatitis

The article was professionally consulted with Master, Specialist Doctor II Phan Thi Minh Huong - Gastroenterologist - Department of Examination & Internal Medicine - Vinmec Danang International General Hospital.

Severe acute pancreatitis is an acute inflammation of the pancreas that leads to damage to the follicular cells, causing destruction of pancreatic enzymes to a severe degree and even death. Understanding the cause of severe acute pancreatitis helps patients and treating doctors make an accurate diagnosis to have an appropriate and effective treatment plan.

Acute pancreatitis is an acute inflammatory process of the pancreas that manifests itself in many different levels: mild, requiring only a short hospital stay and few complications. In contrast, severe pancreatitis has a complex disease course. The mortality rate of severe acute pancreatitis is quite high, with about 20 to 50% of cases with multi-organ failure and infection.
Studies conducted on cases of acute pancreatitis have shown that in cases of acute pancreatitis, elevated levels of cytokines in the blood that promote inflammatory responses are considered as the main cause of multiple failure. organs in severe acute pancreatitis. Therefore, patients with severe acute pancreatitis need to be treated early according to the pathogenesis without waiting for clinical manifestations to reduce the mortality rate from 40 to 50% to about 10 to 15%.

2.1. Hypertriglyceridemia Severe acute pancreatitis due to hypertriglyceridemia rarely occurs with triglyceride levels below 20 mmol/l, but this mild and moderate elevation plays a major role in the early phase of pancreatitis. However, because triglycerides are considered as a product of rapid increase after a high-fat meal, about 10% of patients with acute pancreatitis on admission have a triglyceride level higher than 20mmol/l and this index may be higher than 20mmol/l. rapidly decreased after 72 hours of treatment.
The mechanism of causing severe acute pancreatitis due to elevated triglyceride levels has not been elucidated yet, but experts believe that chylous particles containing triglyceride-rich lipoprotein particles are the main cause of inflammation in the liver. pancreas.
Chilli may initially appear in the blood as triglyceride levels rise. It follows the circulatory system to the pancreas, the chylothorax granules gradually enlarge, causing blockage of the pancreatic capillaries and causing the pancreatic acinar in the ischemic areas to rupture, when these chylothoraxes will come into contact with pancreatic lipase.
Proinflammatory factors due to unesterified free fatty acids damage the acinar and microvessels of the pancreatic parenchyma. When inflammation in the pancreas begins to occur, a systemic inflammatory response syndrome is initiated with the role of cytokines and other chemical mediators of pancreatic inflammation. A strong systemic inflammatory response may be considered as a major factor leading to clinical severe multiorgan failure syndrome in cases of severe acute pancreatitis.

2.2. Alcohol abuse causes severe acute pancreatitis Alcohol can cause narrowing of the small tubes that drain fluid in the pancreas, leading to blockage and causing acute pancreatitis. People who drink heavily on a regular basis and over a period of time can cause chronic pancreatitis. However, a severe episode of acute pancreatitis can occur during a single binge of drinking too much alcohol or eating a large meal.

2.3. Other causes of severe acute pancreatitis Mechanical causes include Gallstones, pancreatic stones. Hypercalcemia causes thyroid tumors, hyperparathyroidism. After surgery, especially abdominal surgery near the pancreas or around the pancreas. After endoscopic retrograde cholangiopancreatography. Abdominal injury or bruising. After organ transplantation: Complications after liver and kidney transplantation can be mentioned. Acute fatty liver in pregnancy. Having infections such as some related diseases such as mumps, viral hepatitis, roundworms. Use of drugs, such as sulfonamides, 6MP, furosemide, ehtamol,... Organism-linked pathologies such as systemic lupus erythematosus, necrotizing vasculitis,... About 10% of cases of inflammation Severe acute pancreatitis of unknown etiology.

Pancreatitis is often caused by gallstones or excessive alcohol consumption. Therefore, people at risk for this disease should adopt a healthy lifestyle to reduce their chances of developing inflammation in the pancreas.
Gallstones can be effectively prevented with a daily diet rich in vegetables. Eating more whole-grain breads, oats, and grain products reduces the amount of fat in the body and can help lower cholesterol in the body.
Being overweight is also considered a risk factor for developing gallstones. Maintaining weight with a reasonable and balanced diet combined with exercise can help reduce this condition. Reducing alcohol and tobacco use can also prevent the pancreas from being damaged.
Above are some possible causes of severe acute pancreatitis and some preventive measures. Please follow the website: Vinmec.com regularly to update many other useful information.

Reference sources: benhviendktinhquangninh.vn, dieutri.vn, bacsinoitru.vn