Treatment of Severe Pancreas and Related Cases
I. Overview of acute pancreasitis
Severe pancreas disease is an acute abdominal condition with a high degree of distress, complications and mortality. It usually causes the inflammation of the pancreatic tissue itself, oedema, haemorrhaging and even necrosis after the insulin is activated in the pancreas, with multiple causes. Common causes include cholesterol diseases (e.g., cholesterol, cholesterol infections, etc.), alcohol abuse, diarrhea, hyperplasia, etc.
II. Treatment for severe pancreas disease
1. Non-surgery
• fasting and gastrointestinal decompression: reducing gastric acidity through fasting, which in turn reduces insulin; gastrointestinal decompression can extract gas and liquids from the stomach, reduce abdominal swelling and prevent vomiting, which is important for mitigating the condition. The general period of fasting, depending on the condition, may last from days to weeks.
• Refilling and nutritional support: The frequent occurrence of water, electrolytic disorders and acid alkali imbalance by patients due to fasting, vomiting, etc., requires a large amount of rehydration to maintain cyclic stability. After a slight stabilization of the condition, if the patient is unable to eat via mouth, nutritional support can be provided either by nasal feed or by an intravenous route, such as infusion of amino acid, fat milk, glucose, etc., to meet the aerobic metabolic needs.
Insulin inhibition: Common drugs have growth inhibitors and their analogues (e.g., accelerants), which effectively inhibit the ingestion of insulin, cholesterol, etc., and reduce the digestion of pancreas itself, generally requiring constant intravenous dripping for a period of time, depending on the condition.
Anti-infection treatment: Patients with severe pancreas are susceptible to co-infection, and if the infection is suspected or diagnosed, the anti-infection treatment of sensitive antibiotics, e.g., head bacterium, carbon cyanide, etc., needs to be based on a drug-sensitive test, usually with longer treatment.
• Pain treatment: Patients are often accompanied by severe abdominal pain and can be given appropriate analgesics, such as diatoms, after a clear diagnosis, but morphine is prohibited, as it can cause Oddi absemic convulsions and aggravates insulin discharges, thus exacerbating the condition.
Surgery
• Timing of the operation: it is generally considered in the event of serious complications such as ineffective non-surgery treatment, continued deterioration of the condition, co-infection of pancreas deaths, intraperitoneal hysteresis, etc.
• Surgical methods: it is common to have pancreatic necropsy, which removes the inflammation of carcinose tissues and the surrounding inflammation, and cholesterol infestation, which may require cholesterol detection, stone extraction, etc. to remove the cause.
III. Cases related to severe pancreas disease
Case I: Insulinitis of the cholesterol
Mr. Liu, 45 years old, has a history of gallstone disease. Following a festivities, the abdominal pain continued to be severe, with radiation to the back and symptoms of nausea, vomiting and fever. Upon admission to emergency care, the examination found a significant increase in blood starch enzymes and fat enzymes, and C.T. in the abdomen showed that pancreas were swollen, that there was a visible seepage and that severe pancreasitis was diagnosed and considered to be the cause of gall.
Upon admission to hospital, non-surgery treatments such as fasting, gastrointestinal decompression, a large amount of rehydration, and accelerants are given. At the same time, the empirical choice is for anti-infection treatment with a tungsten. After a week of active treatment, Mr. Liu ‘ s symptoms were reduced, but he was still suffering from hypothermia, and a review of the abdominal CT revealed an increasing trend of pancreas necrosis and co-infection.
As a result, the doctors decided to perform surgical treatment, performing pancreas tissue removal and choreography. Treatment for infection resistance, nutritional support, etc. continues after the operation. After almost two weeks of recovery, Mr. Liu ‘ s condition has stabilized, his body temperature has returned to normal, indicators have improved and he has been discharged.
Case II: Insulinitis, hyperfatable.
Ms. Zhang, 32 years old, is obese, regularly eats irregularly and likes greasy food. All of a sudden, the pain in the abdomen was unbearable and continuous, accompanied by vomiting and breathing difficulties. At the hospital, hematase, fat enzymes were too high and the levels of triester glycerine were far above normal, and the abdominal CT showed widespread necrosis, which was diagnosed as hyperfatal acute pancreas.
In the early stages of treatment, insulin has been used to reduce blood resin, in addition to routine fasting, gastrointestinal decompression and rehydration, while insulin has been used to contain insulin. Due to her serious condition, Ms. Zhang suffered from complications such as acute respiratory distress syndrome (ARDS) and was transferred to ICU for care.
During the period of the ICU, mechanical ventilation was provided to support breathing and continued anti-infection and nutritional support treatment. After nearly a month of hard treatment, Ms. Zhang ‘ s condition has gradually improved, the insulin tissue has gradually been absorbed, and complications have been effectively controlled, and eventually transferred from the ICU, continuing to recover from the general ward and then being discharged after a period of time.
Case III: Insulinitis, alcohol-intensive
Mr. Wang, 38 years old, has been drinking. On one occasion, there was a severe abdominal pain associated with frequent vomiting, diarrhoea and fever. Upon admission to hospital, the diagnosis was severe pancreas disease, which was related to excessive alcohol consumption.
The treatment began with basic treatments such as fasting, gastrointestinal decompression and rehydration, as well as the use of accelerants to contain insulin. However, during his treatment, Mr. Wang suffered from abdominal space syndrome and a sharp rise in internal pressure, which seriously affected the functioning of the organs.
In view of this, the doctor performed urgent operations, mainly to remove pancreatic carcinogenesis and to take measures to reduce internal pressure. Post-operative co-operation with ongoing anti-infection, nutritional support, etc. After nearly three weeks of treatment, Mr. Wang ‘ s condition has gradually improved, his internal pressure has returned to normal, his indicators have been normalized and he has been discharged.
The treatment of acute pancreas is a complex and lengthy process, requiring a combination of non-surgery or surgical treatments based on the patient ‘ s specific causes, development of the condition and complications, while keeping a close watch on the patient ‘ s evolving condition in order to improve the patient ‘ s recovery and reduce the rate of death.
