Acute hemorrhagic necrotizing pancreatitis
Introduction
Introduction to acute hemorrhagic necrotic pancreatitis Acute hemorrhagic necrotic pancreatitis is a type of acute pancreatitis that is caused by the continued development of acute edematous pancreatitis. Pancreatic acinar, fat, large vascular necrosis, pancreatic tissue edema, enlarged volume, extensive hemorrhage and necrosis. A large amount of bloody exudate in the retroperitoneal space. The omentum and mesangial tissue are digested by the exuded trypsin. This type of pancreatitis is a serious condition with rapid development, many complications, and high mortality. basic knowledge The proportion of illness: 0.05%, more common in patients with cholecystitis Susceptible people: no specific population Mode of infection: non-infectious Complications: shock acute pancreatitis
Cause
Causes of acute hemorrhagic necrotic pancreatitis
The disease is a rare type of acute pancreatitis, the main cause of which is acute pancreatitis.
There are many causes of acute pancreatitis, and its pathogenesis is also controversial. The etiology of this disease is related to the following factors:
First, biliary diseases account for 50-80% of the most common causes in China;
Second, the pancreatic duct infarction can cause obstruction of the pancreatic duct due to aphids, stones, edema, tumor or paralysis;
Third, the duodenal papilla adjacent lesions;
4. Alcoholism and overeating are the main causes of Western countries;
5. Surgery and injury;
Sixth, other hypercalcemia and hyperparathyroidism can induce acute pancreatitis; drugs; some infectious diseases such as mumps, viral hepatitis, etc. may be associated with pancreatitis.
Prevention
Acute hemorrhagic necrotic pancreatitis prevention
Actively treat diseases such as biliary tract diseases that can cause the disease, quit smoking and avoid overeating.
Complication
Acute hemorrhagic necrotic pancreatitis complications Complications, shock, acute pancreatitis
Susceptible to shock, acute pancreatitis and other complications.
Symptom
Acute hemorrhagic necrotic pancreatitis symptoms Common symptoms Abdominal pain with shock Abdominal tenderness Pain high fever Upper abdominal mass Bloody exudate umbilical cord around umbilical bowel movement Mobility shock
Symptom
Severe upper abdominal pain or hyperthermia during the treatment of acute edematous pancreatitis, diffuse peritonitis, paralytic ileus, upper abdominal mass, gastrointestinal bleeding, neuropsychiatric symptoms, shock.
2. Signs
Abdominal bulging, tenderness and rebound tenderness, mobile dullness, bowel sounds disappeared, a small number of patients due to bloody exudate containing pancreatic enzyme infiltrated into the subcutaneous space through the retroperitoneal space, subcutaneous fat necrosis, bilateral abdominal wall ecchymoses and umbilicus fade.
Examine
Examination of acute hemorrhagic necrotic pancreatitis
1 hematuria amylase may continue to increase or due to extensive necrosis of the pancreas without elevation, blood calcium decreased, its value <1.74mmol / L (7mg), the prognosis is poor, blood sugar increased, diabetes, serum methemoglobin positive.
2 abdominal puncture fluid opacity, amylase, lipase increased.
3B type ultrasound examination showed pancreatic enlargement, and the internal light spot reflection was rare. CT showed diffuse enlargement of the pancreas, irregular shape, blurred edges, and widening of the peripancreatic space.
Diagnosis
Diagnosis and diagnosis of acute hemorrhagic necrotic pancreatitis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Must be differentiated from acute gastroenteritis, acute perforation of ulcer disease, acute cholecystitis of cholelithiasis, myocardial infarction, acute intestinal obstruction, ischemic embolization of mesenteric vessels.
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