The most important thing that should be done immediately if there is an attack of acute pancreatitis or exacerbation of chronic pancreatitis is to call an ambulance. After urgent measures designed to remove or at least reduce pain, the patient is necessarily hospitalized in a surgical hospital, and already at the waiting room the doctor decides whether to place the patient in general surgery, in the intensive care unit or in intensive care.
As most surgeons, resuscitators and anaesthesiologists believe, it is imperative to identify in the resuscitation unit patients who have two or more symptoms from the following list:
- Pancreatic shock with concomitant acute stomach manifestations;
- Acute respiratory failure caused by an attack of pancreatitis;
- Acute frustration in the field of the psycho-neurological sphere, resulting from toxemia;
- Acute renal failure( or renal-hepatic insufficiency), resulting from the progression of pancreatitis or peritonitis;
- Dynamic bowel obstruction caused by peritonitis or toxemia.
A patient with such signs of pancreatitis is placed in the intensive care unit where he undergoes necessary examinations determining the severity of the course of the disease while simultaneously applying the following treatment methods:
- curative fasting for up to three days;
- detoxification and maintenance infusion therapy designed to provide vital functions of the pancreas;
- pharmacological cessation of the secretion of enzymes produced by the pancreas;
- in case of severe forms, with the risk of developing pancreatic necrosis, the patient receives antibacterial therapy with wide-spectrum drugs;
- for complex forms of pancreatitis is used intravenous and intraarterial forced diuresis, designed to urgently remove pancreatic enzymes from the body and ensure its complete detoxification;
- if during the patient's stay in the intensive care he has a large amount of hemorrhagic or serous exudate in his abdominal cavity, he should undergo peritoneal dialysis.
After removal of the acute condition, the patient is transferred from the intensive care unit to the intensive care unit or to the general department.