Hemorrhagic pancreatitis

 

Hemorrhagic pancreatitis

 

If your pancreas, which is located on the left side of your upper abdomen, becomes inflamed, we will have pancreatitis. The inflammation of the pancreas can be acute or chronic. In some cases, following acute inflammation of the pancreas or acute pancreatitis, bleeding in or around the pancreas occurs that is called hemorrhagic pancreatitis.

 

In the following, we will explain more about the causes, symptoms, treatment and prognosis of acute hemorrhagic pancreatitis.

 

What you will read next :

What is hemorrhagic pancreatitis?

How does acute pancreatitis develop?

What causes hemorrhagic pancreatitis?

What are the symptoms of acute hemorrhagic pancreatitis?

How is acute (hemorrhagic) pancreatitis diagnosed?

What is the treatment for acute (hemorrhagic) pancreatitis?

What is the prognosis of acute hemorrhagic pancreatitis?

What is the mortality rate from acute hemorrhagic pancreatitis and necrotizing?

 

 

 

 

 

What is hemorrhagic pancreatitis?

Sometimes, following acute inflammation of the pancreas, which is called acute pancreatitis, hemorrhagic pancreatitis also occurs, so it is better to know a little about the pancreas and acute pancreatitis first.

 

The pancreas is located on the left side of the upper abdomen and is responsible for making insulin and some of the essential nutrients for digestion in the intestines. These are called lipases (enzymes of fat digestion) and amylase.

 

How does acute pancreatitis develop?

Sometimes the enzymes in the pancreas, which are responsible for digesting food and must be excreted into the small intestine, do not work properly.

 

Following this process of self-digestive pancreas and inflammation, edema and swelling also occur. Sometimes this self-digestion destroys the walls of blood vessels in and around the pancreas and causes bleeding, which is called hemorrhagic pancreatitis. As the process of self-digestion and vascular destruction progresses, the tissues of the pancreas die, which is called necrosis of the pancreatic tissue. This step is called Hemorrhagic and necrotizing pancreatitis.

 

Certainly, pancreatitis with untreated necrosis can lead to an extensive infection (septicemia), organ dysfunction, and even death.

 

Improper activation of pancreatic enzymes causes digestion of pancreatic gland tissue and digestion of pancreatic fats and destruction of blood vessel walls, bleeding and tissue necrosis.

 

What causes hemorrhagic pancreatitis?

We said that hemorrhagic pancreatitis is caused by acute inflammation of the pancreas or acute pancreatitis, the following can cause this inflammation:

 

  • Excessive alcohol consumption
  • Gallstones
  • Diseases of the bile ducts of the liver
  • Trauma

 

Some viruses (mumps, Coxsackie virus (starts with fever, anorexia and cough and gradually causes mouth sores and pimples on the palms and soles)

, Hepatitis viruses)

  • High blood calcium (hypercalcemia)
  • Hyper triglyceride
  • Some medications:
  • Tetracycline
  • Sodium valproate
  • Some chemotherapy drugs
  • Prednisolone
  • Estrogens
  • Frusemide
  • Sulfacetamide and family drugs

 

What are the symptoms of acute hemorrhagic pancreatitis?

If you have any of the following symptoms, it is best to see an equipped health center:

 

  • stomach ache:

Acute pancreatitis is a severe and persistent pain that often begins one to four hours after eating or drinking large amounts of alcohol. The pain spreads to the back.

The patient tries to reduce the pain by bending forward, in other words, bending forward reduces the pain caused by acute inflammation of the pancreas.

  • Nausea
  • Vomit

 

  • Side bruising due to hemorrhagic pancreatitis:

It is called the Grey Turner's sign

 

  • Bruising around the navel in hemorrhagic pancreatitis:

It is called the Cullen sign.

Also, observing and experiencing the following signs and symptoms can indicate the severity of pancreatitis:

  • Fever
  • Abdominal distention
  • Increase heart rate
  • Lung hydration (pleural effusion)
  • Symptoms of Cullen (blue around the navel) and Turner (blue, red, purple or green on the sides due to hemoglobin tissue catabolism)
  • And shock (severe hypotension that prevents enough blood from reaching various organs of the body and if left untreated will cause them to fail)

 

How is acute (hemorrhagic) pancreatitis diagnosed?

Taking a history and examination along with the following tests and imaging will be effective in diagnosing acute pancreatitis:

 

  • Your doctor will order a CT scan or MRI
  • The level of pancreatic enzymes, such as amylase and blood lipase, is measured
  • Liver activity tests also include measurements of liver enzymes
  • Performing invasive interventions if you notice symptoms of bile duct obstruction (called ERCP).

 

(Interestingly, sometimes this method itself causes acute pancreatitis)

 

Diagnostic points are extensive and are not fully covered in this article.

 

What is the treatment for acute (hemorrhagic) pancreatitis?

The following can be effective in treating acute pancreatitis:

  • The patient should not eat anything for a while so as not to temporarily stimulate the secretion of pancreatic enzymes.
  • Fluid therapy through the administration of appropriate serum (the most important component of treatment)
  • Suction of stomach contents
  • Control of patient’s pain with drugs (meperidine); Morphine should not be used to relieve the pain of acute (hemorrhagic) pancreatitis as it will aggravate the problem.
  • Control of calcium and triglycerides in the patient's blood
  • Prescribe appropriate antibiotics

 

In the following cases, surgery should be performed to save the patient:

  1. When we face extensive necrosis (tissue death)
  2. When we have severe acute hemorrhagic pancreatitis that has not responded to non-surgical treatment.

 

What is the prognosis of acute hemorrhagic pancreatitis?

 

  • People with mild cases usually recover within a week
  • Severe cases of hemorrhagic pancreatitis can be associated with sepsis, shock, and death (twenty to forty percent).
  • Physicians use specialized criteria called Ranson criteria to determine the prognosis more accurately, which are not covered in this article.

 

What is the mortality rate from acute hemorrhagic pancreatitis and necrotizing?

We said that evidence such as Cullen sign and Turner sign indicates the presence of hemorrhagic pancreatitis. If more than thirty percent of the pancreatic tissue is dead and necrotic, there is an eleven to twenty-four percent chance that the infected person will die.

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