Can statins cause pancreatitis
Life threatening acute pancreatitis
Fortunately, the acute illness usually heals without complications. However, the higher the degree of pancreatic necrosis, the worse the chances of survival. With partial necrosis, from which about every third patient suffers, the lethality is between 15 and 50 percent, with complete necrosis (about 10 percent of patients) it is over 80 percent. Weitz named the bacterial infection of the necrotic foci with subsequent sepsis as the most dangerous complication.
Substitute plenty of volume
An early and sufficiently high volume and electrolyte substitution is essential. The loss of fluid in the course of the disease, especially in the retroperitoneal space, but also in the intestinal lumen, the pleural cavity and the abdominal cavity, is very large. This can lead to hypovolaemia and hypoproteinemia. If left untreated, this can lead to circulatory shock, especially since inflammation mediators such as bradykinin also open the blood vessels.
Weitz presented a study by Gardner and colleagues (Pancreatology, Vol. 9 (2009) 770-776). Accordingly, patients with severe acute pancreatitis had a higher chance of survival if they were treated with a high volume dose within the first 24 hours. Several liters per day - according to Weitz an average of six liters - have to be substituted.
Metamizole or other non-steroidal anti-inflammatory drugs (NSAIDs) can be used for analgesia. If opiates are necessary, substances with little spasmogenic effect such as pethidine, buprenorphine or pentazocine are recommended. Morphine, on the other hand, is not recommended as it can lead to sphincter spasm. The doctor said the benefit of a continuous infusion of procaine in acute pancreatitis has not been proven by studies: "No effect, yes side effects."
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