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Suggest Treatment For Acute Pancreatitis

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Posted on Thu, 15 May 2014
Question: My brother is admitted in DMC ludhiana ICU due to pancreas infection. He got gallstone surgery few weeks back ....after 2 week certainly he was in critical condition.... now doctors are saying he is having acute pancreatitis ill diffused necrosis and ascites....everyone is very much depressed in my family.......I will be great thankful to you if you can kindly consider my request..
doctor
Answered by Dr. Grzegorz Stanko (24 minutes later)
Brief Answer:
Detailed below.

Detailed Answer:
Hello!

Thank you for the query.

What exactly would you like to know?
Acute pancreatitis is a common complication of stones which stuck in the bile ducts. So this is the most probable reason. Diffuse necrosis of pancreas leads to sepsis. To prevent it, usually surgery is necessary. Depending of the necrosis range, more than one surgery might be done. During such surgeries necrotic tissues are removed and the drains left to flush the abdominal cavity.
During the whole process he can not eat. Intravenous fluids and nutrition will be given.
In some cases kidney failure can appear. So the temporal intubation and sedation might be necessary in the ICU.

Don't really know much about your brother. So if you could please give some more details about any surgeries, his current condition, any blood work results or abdominal CT results would be helpful in giving better answer.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (7 minutes later)
thanks Doctor ,...

he recently has removed his gallbladder and after 1 weeks pain started in abdomen.

then doctor admitted him in hospital and after 2 weeks he has been shifted into ICU on ventilator support and been there from last 2 weeks..

Doctors are saying his lungs , kidney, liver and heart is safe. and they will drain that necrosis effected fluid and tissues on next week. i already have attached his recent reports on various tests in my profile with name as XXXXXXX XXXXXXX XXXXXXX

please help me to understand:
1. how complicated is this case
2.how much time it takes to recover.
3. what are treatment and steps should have to followed so that we can check with doctor if they are on right track.




doctor
Answered by Dr. Grzegorz Stanko (1 hour later)
Brief Answer:
.

Detailed Answer:
From the results you have attached, it does not look bad. His bilirubin is elevated a little, but the liver tests are not bad.
Very important are WBC, CPR, procalcytonine, amylase levels.

As his kidneys, liver and lungs work property, the prognosis is good. As they didnt decided to the surgery yet, I assume that there is not much of necrosis and he is stable. Lack of fluid in lungs indicates that there is no pathological connection between the abdomen and chest (what sometimes can occur due to pancreatic fistula).
I do not know how it looks in CT.

Answering your questions:
1. It is mildly complicated case. Usually acute pancreatitis is self limiting condition which goes away after a week. So his case is a acute pancreatitis with complications.
2. It may take 4 more weeks or even few more months. Hard to tell. Every case is different.
3. He should have abdominal CT (I`m pretty sure he have had one) and after about a week CT can be repeated. He should have a tube in his duodenum for feeding if possible and get intravenous feeding. Proper antibiotic should be also given. Somatostatin treatment should be considered.
Any abscess in the abdomen should be drained. If pancreas is necrotic and his condition wont is not improving, should be also removed. If the ascites will be still present after 2-3 weeks, this also should be treated with surgery.

Hope this will help. Feel free to ask.
Regards.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5795 Questions

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Suggest Treatment For Acute Pancreatitis

Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. What exactly would you like to know? Acute pancreatitis is a common complication of stones which stuck in the bile ducts. So this is the most probable reason. Diffuse necrosis of pancreas leads to sepsis. To prevent it, usually surgery is necessary. Depending of the necrosis range, more than one surgery might be done. During such surgeries necrotic tissues are removed and the drains left to flush the abdominal cavity. During the whole process he can not eat. Intravenous fluids and nutrition will be given. In some cases kidney failure can appear. So the temporal intubation and sedation might be necessary in the ICU. Don't really know much about your brother. So if you could please give some more details about any surgeries, his current condition, any blood work results or abdominal CT results would be helpful in giving better answer. Hope this will help. Feel free to ask further questions. Regards.