Key points for diagnosis of severe pancreatitis

The pancreas is a small organ located in the abdominal area of ​​the human body, but it plays a very important role. The pancreas can not only secrete pancreatic juice to digest the food absorbed by the human body, but also when we ingest sugar, protein and other ingredients, the pancreas can also absorb these elements well. However, the pancreas is a very fragile area. When bacteria invade the pancreas, it can easily lead to symptoms of pancreatitis. Therefore, it is necessary to understand the diagnostic points of severe pancreatitis.

1. White blood cell count

If the infection is severe, the total white blood cell count increases and there is an obvious nuclear left shift. Some patients have increased urine sugar, and in severe cases, protein, red blood cells and casts are found in the urine.

2. Blood and urine amylase determination

It has important diagnostic significance. Normal values: Serum: 8-64 Winslow units, or 40-180 Somogyi units; Urine: 4-32 Winslow units.

In patients with acute pancreatitis, pancreatic amylase overflows from the pancreas, is rapidly absorbed into the blood, and is excreted in the urine. Therefore, blood and urine amylase levels increase significantly, which is an important laboratory test for diagnosing this disease.

In patients with severe necrosis, the amylase value does not increase because the alveoli are severely destroyed and very little amylase is produced. If the amylase value drops and then rises again, it indicates that the disease is recurring. If it continues to increase, complications may occur. When the measured value is 256 Wen's units or 500 Solomon's units, it is meaningful for the diagnosis of acute pancreatitis.

3. Serum lipase determination

The reason for the increase in its value is the same as that of amylase. It starts to increase 24 hours after the onset of the disease and can last for 5 to 10 days. Measuring its value is helpful for diagnosis of patients with advanced disease.

4. Serum Calcium Determination

The normal value is not less than 2.12mmol/L8.5mg/dl. Blood calcium begins to drop two days after the onset of the disease, and is most significant after the 4th to 5th day. In severe cases, it can drop to below 1.75mmol/L7mg/dl, indicating a serious condition and a poor prognosis.

5. Serum ferritin MHA determination

MHA comes from the heme released by the destruction of red blood cells in the bloody pancreatic juice. Under the action of lipase and elastase, it is converted into heme, which is absorbed into the blood and combines with albumin to form methemoglobin. MHA often appears in severe patients 12 hours after onset. It is positive in patients with severe acute pancreatitis and negative in patients with edema type.

6. X-ray examination

Localized or generalized intestinal paralysis may be seen in the abdomen. There is fluid and air accumulation in the lesser omental sac. There are calcifications around the pancreas. Diaphragmatic elevation, pleural effusion, and occasional discoid atelectasis may also be seen. When ARDS occurs, the lung fields may appear "ground glass."

7. Ultrasound and CT

Both can show the outline of pancreatic enlargement and the amount and distribution of exudate.

Although pancreatitis still has a certain impact on our lives, with the development of medicine, pancreatitis is no longer a big deal. Accurate diagnosis and examination will allow pancreatitis patients to better understand their condition, which is especially important for future recovery.