Particularly dangerous complications of acute pancreatitis

The article was professionally consulted by a doctor of Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Acute pancreatitis is an acute disease of the pancreas that can range from edematous pancreatitis to hemorrhagic and necrotizing pancreatitis. This is a common abdominal emergency, if not treated in time can cause dangerous complications and even lead to death.

There are many causes of acute pancreatitis and are divided into 3 main groups as follows:
Alcohol: is the main cause of acute pancreatitis; Due to gallstone obstruction leading to obstruction of the common duct or sphincter of Oddi blocking the pancreatic duct flow. The retained pancreatic enzymes cause destruction of the pancreatic structure. Hypertriglyceridemia high >1000mg/dL In addition, acute pancreatitis can also occur due to trauma to the pancreas, due to metabolic disorders, autoimmune diseases ..., in which about 10-15% of patients In cases of acute pancreatitis, no cause can be found.

Common signs in acute pancreatitis include:
Acute abdominal pain: Mainly epigastric pain, severe pain, pain occurring suddenly after a meal containing a lot of protein, a lot of fat or after patients drink alcohol. The pain lasts continuously or intermittently, the pain spreads to the back or spreads to the lower ribs on both sides. Acute pancreatitis is often mistaken for stomach pain; Vomiting, nausea: The patient has a feeling of nausea that appears after pain, not related to pain symptoms. Patients often vomit bile, gastric juices or blood; Abdominal distention, or bowel obstruction: Common in patients with severe acute pancreatitis; Accompanying symptoms : Such as consciousness disorder, low blood pressure, oliguria.... Symptoms of pain are similar to acute abdominal pain in gastroduodenal diseases, often appearing after drinking a lot of alcohol. Beer makes patients subjectively not go to the doctor right away, so there are many cases of complications and extremely serious consequences.

If acute pancreatitis is not detected and treated promptly, the disease can cause extremely dangerous complications, the following are common complications of acute pancreatitis:
Hypotension, shock, multiple failure Organ: This is one of the early complications of the disease and can be caused by severe infection or bleeding. Multi-organ failure such as kidney failure, heart failure ... are extremely dangerous diseases; Bleeding: Hemorrhagic complications can appear in the pancreas, or in the abdominal cavity, or in the digestive tract or other organs, leading to damage to the blood vessels. This complication occurs during the first week of illness. All cases with hemorrhagic complications have a severe prognosis; Infection in the pancreas: Occurs at the end of the first week or the beginning of the second week of illness. This is the main cause leading to the formation of abscesses in the pancreas causing generalized peritonitis, tissue necrosis. In this case, the prognosis is severe; Acute respiratory failure: Severe prognosis; Pancreatic pseudocyst: Appears in the 2nd or 3rd week of the disease, caused by the encapsulation process to localize the lesions in the pancreatic parenchyma. Pancreatic pseudocysts contain pancreatic enzymes, fluids, and fragments of pancreatic parenchyma. This cyst may be cleared or self-drained into the pancreatic duct and disappear after 4 to 6 weeks. Cysts if left for a long time can progress to abscess or cause superinfection. The above complications are extremely dangerous, the mortality rate in patients with acute pancreatitis can be greater than 15%, and especially in acute pancreatitis caused by alcohol, 3 times higher than other causes.

The cause of acute pancreatitis is usually gallstones or drinking too much alcohol. Therefore, it is necessary to start with the prevention of gallstones and limit/quit alcohol altogether.
Effective prevention of gallstones: Eat a lot of vegetables, tubers and fruits every day; Eat a variety of foods like wholemeal bread, oats and brown rice; especially reduce fat, because this diet will help reduce the amount of cholesterol in each person's body; Maintain a suitable and healthy weight by using a balanced diet, and exercising regularly. Say no to alcohol and tobacco use: Do not drink alcohol, or immediately reduce the use of alcohol and beer. This will help prevent the pancreas from being damaged; Do not drink more than 14 units of alcohol a week, spread over 3 or more days. One unit of alcohol is equal to about half a liter of normal strength or 25ml of very strong alcohol; If the patient is acute pancreatitis due to heavy drinking, the patient should abstain completely; No smoking.

To prevent dangerous complications of acute pancreatitis, patients need to be serious about following the treatment regimen given by the doctor. In particular, it is necessary to persevere in implementing a healthy diet and lifestyle, especially in the matter of abstaining from alcohol.