How to treat pancreatic nodules

Many people develop pancreatic nodules due to their lifestyle and eating habits, but because most of these nodules are benign, many people don’t pay much attention to them. It is not until a problem occurs that we pay attention and realize its seriousness. In fact, pancreatic nodules may cause abdominal pain, and some may even cause diabetes. As people's understanding of medical diseases gradually deepens, they also have a certain understanding of pancreatic nodules. So many people will ask, how to treat pancreatic nodules?

Chronic pancreatitis is a disease in which the pancreas is destroyed gradually due to repeated attacks of acute pancreatitis. In some cases, the acute phase is not obvious, the symptoms are hidden, and the disease is already chronic when discovered. Clinically, it is often accompanied by biliary system diseases, and patients have upper abdominal pain, fatty diarrhea, and sometimes diabetes. Chronic alcoholism also often causes this disease.

Macroscopically, the pancreas appears nodular and hard. The cut surface shows hyperplasia of pancreatic interstitial fibrous tissue, dilatation of the pancreatic duct, and occasional stones formed in the duct. Sometimes pancreatic parenchymal necrosis can be seen. After the necrotic tissue liquefies, it is surrounded by fibrous tissue to form a pseudocyst. Microscopically, proliferation of fibrous tissue or extensive fibrosis can be seen around the pancreatic lobules and between the alveoli, atrophy and disappearance of the alveoli and pancreatic tissue, and infiltration of lymphocytes and plasma cells in the interstitium.

Choose appropriate treatment based on clinical manifestations and classification.

1. Non-surgical treatment should be used in the early stages of acute pancreatitis, for mild pancreatitis and for those without infection.

(1) Fasting and nasogastric tube decompression: Continuous gastrointestinal decompression to prevent vomiting and aspiration. Giving whole-body motility drugs can reduce abdominal distension.

(2) Replenish body fluids and prevent shock: All patients should be supplemented with fluids, electrolytes, and calories intravenously to maintain circulatory stability and water and electrolyte balance. Preventing hypotension, improving microcirculation, and ensuring pancreatic blood perfusion are beneficial for the treatment of acute pancreatitis.

(3) Antispasmodics and analgesics: for those with a clear diagnosis. In the early stages of the disease, analgesics (pethidine) can be given symptomatically. However, it is advisable to give antispasmodics (scopolamine, atropine) at the same time. Morphine is contraindicated to avoid spasm of the sphincter of Oddi.

(4) Inhibition of pancreatic exocrine secretion and pancreatic enzyme inhibitors: gastric tube decompression, H2 receptor blockers {such as cimetidine), anticholeretics (such as scopolamine, atropine), somatostatin, etc., but the latter are expensive and are generally used for patients with more serious conditions. Trypsin inhibitor

For example, aprotinin and gabexate have a certain inhibitory effect on trypsin.

(5) Nutritional support: early fasting. Mainly rely on total parenteral nutrition (TPN). When the abdominal pain, tenderness and intestinal obstruction symptoms are relieved, you can resume eating. Except for patients with hyperlipidemia, fat emulsion can be used as a heat source.

(6) Antibiotic use: Early antibiotic treatment. In severe pancreatitis complicated by pancreatic or peripancreatic necrosis, intravenous administration of broad-spectrum antibiotics or selective intestinal administration of antibiotics can prevent bacterial and fungal infections caused by intestinal flora translocation.

(7) Treatment with traditional Chinese medicine: When vomiting is basically under control, inject traditional Chinese medicine through a gastric tube and clamp the tube for 2 hours after injection. Commonly used as compound

Qingpi Decoction with modifications: honeysuckle, forsythia, coptis, scutellaria, magnolia bark, fructus aurantii, costusroot, safflower, and raw rhubarb (added last). You can also use 15g of raw rhubarb alone by intragastric tube instillation. Twice a day.

(8) Treatment of peritoneal exudate: The peritoneal exudate of acute pancreatitis contains a variety of harmful substances that can cause hypotension, respiratory failure, liver failure, and changes in vascular permeability. In severe pancreatitis, it is generally believed that peritoneal exudate can be absorbed spontaneously. If there is obvious abdominal distension and a lot of peritoneal exudate, peritoneal lavage should be performed.

From the above, we can see that pancreatic nodules can be completely cured if treated in time. Generally speaking, they can be controlled by medication or surgical treatment. If not treated in time, the consequences will be very serious. Therefore, when a disease such as pancreatic nodules occurs, it is best to go to a regular professional hospital for timely treatment.