Acute pancreatitis: symptoms, treatment, complications, causes

Acute pancreatitis is a progressive inflammatory process in the pancreas that begins with the death of the gland cells and the release of enzymes from them, which leads to melting of the organ tissue and its dystrophy.

The disease is severe, leading to a high mortality rate despite current treatments.

His diagnosis and treatment are performed by abdominal surgeons in a hospital.

The essence of the pathology of

The disease is triggered by the release of activated enzymes from the gland cells, which must be present as inactive proenzymes. This can occur with:

• increase in pressure in the main duct of the gland;
  
• partial overlapping of that mouth in the duodenum, into which the duct of the pancreas flows;
  
• reverse the entry of bile into the pancreatic duct.

With the activation of pancreatic enzymes, the edema of the organ develops and the death of some of its parts. If too many enzymes are released, the organs adjacent to the gland will melt;In the blood, a large amount of tissue degradation products enter the bloodstream, which causes severe intoxication.

If the body can withstand intoxication, immunity begins to "bomb" the foci of those killed in the pancreas cells. In the body, an infiltrate is formed, a fever develops, the stomach and biliary tract are affected.

The next stage is suppuration of dead pancreas and fatty tissue around it. Pus may leak into the free abdominal cavity, break into the pleural cavity, dissolve the walls of vessels of different calibers.

If a person experiences all these stages, the period of the outcome of the disease comes. Infiltrate resolves, sometimes - with the formation of a chronic process, immunity decreases, infectious lesions of other internal organs develop, disorders of the psyche develop. Severe acute pancreatitis has in the outcome or cyst a gland, or chronic inflammation.

Causes of acute pancreatitis

Acute pancreatitis develops as a result of:

• drinking alcohol, surrogate alcohol;
  
• acute diseases in which the gland is affected: epidemic parotitis, hepatitis B;
  
• abuse of smoked, spicy, fatty and fried foods;
  
• acute pathology of the organs of the hepatobiliary zone and stomach;
  
• surgery and trauma to the gland;
  
• increased secretion of parathyroid glands, in which stones are deposited in the pancreas;
  
• some preparations: antibiotics of tetracycline and sulfanilamide series, cytostatics;
  
• food allergy;
  
• poisoning( heavy metals, paints, solvents);
  
• cystic fibrosis;
  
• violation of the blood supply of the gland in atherosclerosis, thrombosis of arteries, their feeding, aneurysms of the aorta.

Symptoms of acute pancreatitis

Acute pancreatitis does not have such a clear clinical picture to make this diagnosis only on the basis of symptoms. A certain amount of additional research is often required.

The general symptoms of the disease are as follows:

1. 1) Abdominal pain is almost an obligatory sign of the disease. It: more often - surrounding, but can be localized on the left;very strong;cutting character;intensifies with deep inspiration, coughing.
   
2. 2) Nausea, vomiting, which does not bring relief.
   
3. 3) Bloating.
   
4. 4) Cyanotic spots in the navel or on the left side wall of the abdomen.
   
5. 5) A shock can develop rapidly: a drop in blood pressure, confusion, pallor and coldness of the skin, cyanosis of the mucous membranes.
   
6. 6) Liquid stool.
   
7. 7) Temperature increase.
   
8. 8) There may be jaundice of the skin.
   
9. 9) In severe forms of pancreatitis, renal failure may develop, which increases the signs of intoxication( weakness, tachycardia), but the volume of daily urine decreases.

See also: symptoms and treatment of chronic pancreatitis

Diagnosis of acute pancreatitis

To confirm the diagnosis, as well as determine the degree of its severity, stage and possible complications, apply:

1) Laboratory tests:

• general tests of urine and blood;
  
• elevated blood amylase;
  
• high level of urine diastase;
  
• increase in blood glucose level - when the part of the gland in which insulin is produced is affected;
  
• increase in the level of elastase in the stool;
  
• increase in the level of phospholipase in the blood;
  
• also assess the level of ribonuclease in the blood.

2) Ultrasound of the abdominal organs, carried out after preliminary preparation.

3) Fibrogastroscopy, which shows the state of the stomach at the time of development of pancreatitis.

4) CT or MRI of the pancreas.

5) Chest X-ray - to exclude lung damage by pancreatic enzymes.

6) Laparoscopy is a method of investigation when gas is injected into the stomach cavity, pushing away internal organs with it, and then the internal organs are inspected with video equipment.

Treatment of acute pancreatitis

Therapy of acute pancreatitis can be conservative and operative. Treatment begins with the fact that the patient is prescribed hunger( for 3-5 days) and bed rest.

Conservative and minimally invasive methods of treatment are followed:

1) Detoxification by performing purification of lymph or blood( hemo- or lymphosorption).

2) Put the probe into the stomach.

3) Medical therapy:

• elimination of spasm of duct of pancreas and bile ducts: "Papaverin", "No-shpa";
  
• therapy aimed at reducing the production of enzymes: "Contrikal", "Gordoks", in severe cases - "5-fluorouracil";
  
• to reduce the production of hydrochloric acid by the stomach, which includes the formation of enzymes by the pancreas gland: "Omez", "Ranitidine", "Sandostatin";
  
• antibacterial therapy: "Metronidazole", "Ceftriaxone".

Surgical treatment

Surgical treatment of acute pancreatitis, in which the following measures are carried out:

1. 1) Installation of drainage into the abdominal cavity, through which a liquid saturated with enzymes will be discharged outside;
   
2. 2) Removal of dead pancreas;
   
3. 3) The operation, in which the stoma of the stomach, the bile duct, is applied, and the area of ​​the pancreas is drained.

Complications of acute pancreatitis

Acute pancreatitis can be complicated:

• pancreatic necrosis;
  
• sepsis;
  
• reactive pleurisy;
  
• is an inflammation of the liver;
  
• of the pancreas cyst;
  
• pancreatic abscess;
  
• shock;
  
• coma;
  
• mechanical jaundice;
  
• is a chronic process.

Preventive measures

To prevent this life-threatening disease, it is necessary: ​​

• not to consume alcohol;
  
• try to eat small portions, several times a day;
  
• not to abuse fatty, spicy and smoked food;
  
• to comply with all recommendations for treatment and nutrition in case of epidemic parotitis, viral hepatitis, as well as cholecystitis and gastritis;
  
• timely diagnosis and treatment of congenital malformations of the gland and cystic fibrosis;
  
• refusal to take toxic preparations for pancreas, toxins.

I weighed 92 kg! Fat went 3 kg a week! For this, I drank a glass before bed. ..

The nail fungus is afraid of this as fire! If in cool water. ..

Varicose veins disappear in a few days! You just need to spread your legs once a day. ..

The "grandfather's" method to quit smoking! In 7 days you will forget about cigarettes forever!