Pancreas Symptoms of Disease

Pancreatic disease is quite a lot. And the prevention of all diseases of the pancreas is a rational full-fledged nutrition!

Pancreas is one of the most important glands in the body, which performs two main functions. It produces digestive enzymes( enzymes) and isolates them into the duodenum. Enzymes, getting into the digestive tract, decompose carbohydrates, fats and proteins. Another function is the so-called endocrine function, i.e. the function of the endocrine gland. It is performed by beta cells of the islets of Langerhans, producing a hormone insulin. Insulin acts with hyperglycemia, that is, when the sugar content in the blood is high, glucagon produced by alpha cells, acts on the contrary, - eliminates hypoglycemia, or lack of sugar in the blood. Insulin serves in the body primarily to ensure the penetration of glucose into the cells and plays a key role in the metabolism of not only carbohydrates, but fats and proteins.

Pancreatic hormones stimulate the cleavage of fatty acids, which are used by the heart and other muscles, liver, kidneys as an energy material. Violation of the endocrine function of the pancreas causes diabetes. Both functions do not depend on each other. Patients with diabetes mellitus may not have digestive disorders, and patients after severe inflammation of the pancreas do not necessarily have diabetes. Any pathology of the pancreas affects carbohydrate, fat and energy metabolism.

Inflammation of the pancreas occurs due to the action of enzymes activated in the gland tissue and pancreatic ducts, with the difficult isolation of these very enzymes, and is called pancreatitis. Pancreatitis is acute and chronic. How to treat this ailment with folk remedies, look here.

Isolation of enzymes through a common duct can prevent pancreatic edema, blockage of the duct with a stone, or compression from the outside with a tumor. At the same time, the isolation of enzymes ceases, and they begin to digest the tissue of the gland itself, causing acute inflammation - acute pancreatitis, which, if improperly treated, becomes chronic. The causes of pancreatitis can also include infectious diseases, cholecystitis, cholelithiasis, operating injuries, helminthiases, alcoholism, toxic poisoning, thyroid disease, pregnancy, etc.

Acute pancreatitis - degenerative-inflammatory pancreatic disease - is caused by various causes. It is based on self-digestion of the pancreatic tissues due to the action of its own activated enzymes on it - this is an enzymatic-chemical process, to which the infection can join again.
Acute pancreatitis occurs primarily in people who have not previously suffered from pancreatitis. After adequate treatment, the condition, as a rule, is completely normalized.
Acute pancreatitis can be manifested either only by inflammation with the edema of a particular gland, or by necrosis with suppuration and the formation of numerous abscesses( ulcers) in the tissue and hemorrhages, which leads to an extremely serious condition of the patient and often to death even with active treatment.

The main causes of acute pancreatitis:
formation of stones or "sand" in the duct of the gland;
acute cholecystitis;
exposure to alcohol;
of gallbladder disease;
postcholecystectomy syndrome( a condition that occurs after removal of the gallbladder);
is an inflammation of the papilla through which the duct of the pancreas emerges into the lumen of the duodenum;
significant food loads( especially fatty and spicy dishes), feasts with alcohol;
is a drug allergy.
In elderly people, circulatory disorders of the pancreas are added: thromboses, embolisms, atherosclerotic process in the vessels.

In this disease, activated pancreatic enzymes penetrate the tissue of the gland itself, increasing the permeability of the vessels, there is swelling of the organ. In other words, under the influence of various factors, the excretion of digestive juices by the pancreas is disturbed. As a result, instead of digesting food, these juices begin to digest the organ that gave birth to them. Acute pancreatitis is manifested by acute pain in the upper abdomen( epigastric region, right or left hypochondrium), more often surrounding nature. Often there is vomiting, stool, collapse. Collapse is one of the forms of acute vascular insufficiency, characterized by a sharp drop in vascular tone or a rapid decrease in the mass of circulating blood, which leads to a decrease in the venous inflow to the heart, a fall in arterial and venous pressure, brain hypoxia, and inhibition of vital functions of the body. Attachment of infection leads to infectious inflammation of the pancreas.

Depending on the severity of the disorder, acute pancreatitis can also lead to the death of pancreatic cells, which leads to the emergence of a number of toxic substances released into the body. This in turn threatens the patient with a more severe course of the disease. Progressing, the disease can damage other organs, preventing their normal functioning. All patients diagnosed with acute pancreatitis need intensive medical care at the earliest stages of the disease.

The most common cause of acute pancreatitis is gallstones and alcohol. If a stone from the gallbladder enters the main bile duct, it can block the pancreatic duct that connects to the common bile duct in front of the duodenum, which can also cause acute pancreatitis. Alcohol metabolism products can directly damage pancreatic tissue. At the same time, even moderate or rare consumption of alcoholic beverages in people with increased sensitivity to alcohol can cause the disease. At the same time, many people who consume alcohol in excessive quantities, never face the problem of inflammation of the pancreas. Anyway, all patients who have suffered acute pancreatitis should refuse, at least temporarily, from taking alcohol.

In addition to these main reasons for the occurrence of pancreatitis, there are fewer, such as infections, a variety of medications, as well as congenital defects in the development of pancreatic ducts.

Pancreatic dysfunction following acute pancreatitis can result in digestive disorders due to a lack of enzymes responsible for the pancreas and the development of diabetes due to insulin deficiency. However, these problems are corrected by taking enzyme preparations or by replenishing insulin.

Enzyme preparations must be taken strictly at every meal. The dose of the drug varies depending on the nature of the food and the symptoms of the disease. The larger the volume of food, the higher the dose of the drug. At the same time, the feeling of nausea, diarrhea and bitterness in the mouth possible with enzyme deficiency disappear. Drugs that replace natural enzymes, are easily absorbed in the body and, as a rule, do not give side effects, and only in very rare cases, allergic reactions are possible.

If a high blood sugar level is detected due to impaired pancreatic function or surgery, it also requires correction by certain drugs. If the sugar level is not too deviated from the norm, then it can be adjusted both by nutrition and by drugs affecting the level of glucose in the blood. Treatment directly with insulin can become necessary with a high glucose content in the blood.

Chronic pancreatitis most often develops after acute pancreatitis, as well as with liver diseases, atherosclerosis, thyroid diseases, hemochromatosis, ulcerative colitis. In chronic pancreatitis, normal pancreatic tissue is gradually replaced by scar tissue. As with acute pancreatitis, chronic pancreatitis should be treated and not let on "drift" disease.

The main symptom of chronic pancreatitis is acute pain in the upper abdominal cavity. Constant and prolonged inflammatory processes in the pancreas can lead to the destruction of healthy cells. As a result, cells become scar tissue, which inhibits the natural functioning of the pancreas. This negatively affects the production of digestive enzymes responsible for the breakdown of food and its further digestion by the body. There are diarrhea( often fetid), weight loss, lack of vitamins. Because of the destruction of pancreatic cells, a limited amount of insulin is released, metabolic processes affecting the sugar content in the blood are disturbed, which leads to diabetes mellitus.

For the correct diagnosis and more successful treatment, the participation of specialists in echo- tomography and endoscopy is necessary.

Usually patients with pancreatic necrosis enter the hospital in the phase of toxemia. If the level of amylase is increased in the blood and urine of the patient, the work of the gland( pancreatic secretion) is blocked with the help of medications. Usually, the drug 5-fluorouracil is intraarterially administered.

In order to reduce pancreatic secretion, reduce the acidity of gastric juice. For this purpose, for example, cimetidine and atropine are used.

Next, doctors are taking steps to restore the out-cut outflow of pancreatic secretions. For this purpose, special surgery is performed when the sphincter of the papilla is dissected( endoscopic papillosphincterotomy).After this, the level of enzymes in the blood and urine decreases, and the patient's well-being improves.

In pancreatic necrosis, detoxification is also carried out, that is, excess enzymes and cytotoxins are excreted from the body. This is achieved with the help of forced diuresis: intravenously or intra-arterially, special drugs are administered that cause an abundant and frequent discharge of urine. The duration of forced diuresis can reach a week.

If a patient with pancreatic necrosis in the abdominal cavity is found a fluid with an admixture of blood, laparoscopic dialysis is prescribed. It is carried out with the help of drains, through which the liquid is pumped out and a solution consisting of novocaine, sodium chloride and antibiotics is injected. As soon as the fluid flowing from the abdominal cavity becomes transparent, and the level of amylase in it decreases, the procedure is terminated. In cases of increasing intoxication and with acute pancreatitis complicated by jaundice, hemosorption, or purification of blood, is carried out.

With the correct treatment, the phase of toxemia of pancreatonecrosis results in the patient recovering. However, it also happens that the stage of infiltration and purulent complications develops. Then the patients are prescribed broad-spectrum antibiotics, which are injected through the femoral arteries. Usually after this infiltrate dissolves.

If the positive effect of the treatment does not occur, the patient is prepared for surgery, during which dead pancreatic tissue is removed.

The prognosis of the disease depends on how seriously the pancreas is seriously affected and whether treatment is started in time.

Another danger can lie in wait for the pancreas from its nearest neighbor - the gall bladder, if it contains stones, can cause big trouble. Simultaneous combination of diseases extrahepatic bile ducts( mainly the gallbladder) and the pancreas can lead to the development of cholecystopancreatitis.

Indeed, pancreatitis that occurs against the background of a dysfunctional gallbladder, account for more than half of all cases of inflammatory diseases of the pancreas. More often cholecysto-pancreatitis selects women as its target. And it should be noted that our reader is still lucky, because in this particular case, cholecystopancreatitis has declared itself rather delicately. Let's figure out why this disease arises and how to treat it.

The main cause of cholecystopancreatitis is gallstones. And if we say that stone-breaking is a time-bomb in our body, ready to explode at any moment, it is unlikely to be such a big exaggeration.

Of course, stone stone is different, but if large formations can lead to pressure sores, gall bladder breakthroughs, then small stones are artful in their own way. They can migrate and penetrate the bile ducts. Wandering through them, the stones reach the level of confluence in the duodenum and there they get stuck. Due to the violation of the outflow of bile, the pigment of bilirubin begins to accumulate in the blood, and mechanical jaundice arises. In addition, a severe attack of cholecysto-pancreatitis can develop rapidly. In this case, it is no longer up to speculation, whether it is necessary to remove the gallbladder - doctors need an ambulance.

And if you do not want to part with your gallbladder, then you know that if a stone appears in the gall bladder, it will never completely dissolve. The presence of even the smallest pebbles suggests that the gallbladder is broken - the bile begins to precipitate. And if this trend has appeared, it will only develop.

Usually clinically acute cholecystopancreatitis begins with a typical attack of acute cholecystitis. After the error in the diet, food lovers "fatter and more pozhariste" have pain in the right upper quadrant, which gives to the right shoulder blade and the right shoulder. Often there is vomiting of bile, the temperature rises. At this stage, leukocytosis is found in the blood with a shift of the leukocyte formula to the left. Ultrasound reveals gallstones, swelling.

Then there are signs of acute pancreatitis, which you already know well: the pain becomes more severe, assumes a shingling character, agonizing vomiting, the phenomena of dynamic intestinal obstruction join. In the urine, the content of diastase rises.

Treatment of cholecystopancreatitis includes a set of therapeutic measures used for acute cholecystitis and pancreatitis. After a thorough examination, the doctor will select the necessary medicines and prescribe procedures.

Special attention is paid to diet therapy. At the time of exacerbation of chronic cholecystopancreatitis for 1-2 days, it is better to refrain from eating altogether. You can only drink mineral water "Borjomi", "Bjni", "Slavyanovskaya"( room temperature, without gas) 1 / 2-1 glass 6 times a day, weak and unsweetened tea, broth of dogrose. From the third day from the beginning of an exacerbation with the permission of a doctor, it is possible to gradually include in the diet mucous soups, liquid mashed porridges on water, vegetable purees and fruit juice jelly. After 5-7 days, if there are no complications, it is recommended to switch to a full-fledged diet, but mechanically and chemically sparing. This diet should be observed by the patient during the whole period of exacerbation. After 1.5-2 months you will be able to eat and not eaten dishes.

To help your pancreas, do not rush while eating, chew your food well - crushed, it mixes better with digestive juices, and therefore, is better digested and digested. Eat 5-6 times a day in small portions in strictly fixed hours. At the same time for every meal, bile and pancreatic juice are secreted, also in small portions, which means that both the liver and the pancreas work in a gentle manner.

If you sit down at the table seldom, but at the same time put food on your plate "with a slide", this will require an intensified separation of the digestive juices. In conditions of difficulty in outflow it can provoke a painful attack. And long breaks in food contribute to stagnation of bile and pancreatic juice and thereby maintain inflammation in the gallbladder and pancreas. Dinner should be tried no later than 2-2.5 hours before sleep, because during sleep the food is digested worse.

As the diet you will have to observe for many years, and even for the rest of your life, then it should be full. More information on how to eat with cholecystopancreatitis is described in the fourth chapter of our book.

If you are carrying stones in your gallbladder, our business is to warn you, dear readers, that you are walking along a very very dangerous path. At least, take a survey, do not break the diet, watch yourself in situations where the gall bladder makes itself felt. Because coping with cholecystitis is many times simpler than curing cholecystopancreatitis or pancreatic necrosis, and you should understand this.

That's why in the cold period( without exacerbation) of cholelithiasis, surgeons recommend surgical treatment in a planned order. By the way, today such an operation can be of low traumatic, not requiring dissection of the abdominal cavity. In large clinics and hospitals, removal of the gallbladder is performed by laparoscopy, when the operation is performed through three or four punctures in the abdominal wall. And after a short period of adaptation, the patient can forever forget about cholelithiasis.

As you already know, the pancreas carries hormonal support for the process of digestion. And this is a separate topic for a detailed discussion. Since our book focuses on inflammatory diseases of the pancreas, we address those for whom the problems of treating diabetes are urgent.

How to behave to avoid this disease.

Diabetes mellitus is a disease of the endocrine system caused by absolute or relative insufficiency in the body of the hormone of the pancreas( insulin).You probably already heard about the existence of two different types of diabetes mellitus. And in that, and in another case, the essence of the disease is that the blood glucose concentration rises. However, the mechanisms of occurrence of these two types do not have anything in common with each other, besides they are treated differently.

The first type of diabetes mellitus is associated with a deficiency of the hormone of the pancreas - insulin. That is why it is called insulin-dependent. This type is relatively rare and occurs more often in young people and children. At the second type of insulin diabetes, a sufficient amount is produced. It can be even more than normal. However, the hormone is almost useless, because the tissues of the body lose sensitivity to it. Most often this form of the disease occurs in people over 40 years of age who are overweight

. The main symptoms. Typical manifestations of diabetes are an insatiable appetite and a large amount of urine. Sometimes a person loses up to 6-8 liters of fluid per day. Therefore, do not be surprised at the thirst, which constantly torments diabetics. Increased glucose in the blood gives one more characteristic sign of diabetes mellitus - skin itching. Sometimes it is so painful that the patient is covered with a crust from non-healing scratching. A purulent infection is often associated with mechanical damage, because microbes instantly reproduce in a sweet environment.

Diagnostics. For people without diabetes, fasting blood sugar level is 3.3-5.5 mmol / l, and after meals increases to 7.8 mmol / l( but not higher).Therefore, a blood test for glucose( usually taking blood from a finger on an empty stomach) carries important information for the doctor. To confirm the diagnosis, a sample for glucose tolerance, urine analysis for glucose and ketone bodies and other special studies can also be prescribed.

Treatment. Many people think: well, sugar is slightly elevated in the blood, so what? However, such an "insignificant" increase in sugar in the absence of proper treatment sooner or later leads to myocardial infarction, stroke, blindness, gangrene, chronic renal failure. All these complications of diabetes are associated with access to disabilities, not to mention the fact that they are shortening life. Why so start the disease? It is better to be examined as soon as possible and begin treatment.

Patients with the first type of diabetes mellitus regulate blood sugar levels by injecting insulin. With type 2 diabetes, the doctor usually prescribes hypoglycemic drugs in tablets - that is, one small tablet is enough to ensure a normal blood sugar level during the day.

Prognosis and prevention. How not to get diabetes? There are no guarantees, but it is quite possible to significantly reduce the risk of the disease. Hence the first rule of prevention - not to abuse sweet. After all, every "injection" into the body of sugar causes the cells of the pancreas to feverishly produce an insulin neutralizing it. If this happens year after year five to six times a day, the islands of Langerhans may not be able to bear the load. Especially you need to monitor the amount of sugar, honey, white bread, potatoes and starch in the diet for those who have a hereditary predisposition to diabetes. Another factor that can wake up diabetes is excessive physical activity. So in the struggle for an ideal figure, one should not forget about common sense.

Among tumors of the pancreas, benign and malignant neoplasms are isolated. To benign include adenoma, cystadenoma, fibroma, lipoma, neurinoma and some others. Hormone-active tumors of islet apparatus - insuloma and gastrinoma, which release hormones stand apart. The course of them is also in most cases benign, and the treatment consists in the operative removal of the tumor node by vyluschivaniya.

Malignant tumors of the pancreas most often occur cancer, which most often leads to death after lung, colon and breast cancer.

The exact cause of pancreatic cancer has not yet been clarified, but there are known risk factors that can contribute to its development. You have the opportunity to analyze: does not any of the factors listed below have a personal relationship to you?

Age. The risk of pancreatic cancer increases with age. Almost all patients with pancreatic cancer are over 50 years old.

Gender. Men get sick 1,5-2 times more often than women.

Race. African Americans are more likely to have pancreatic cancer than white people.

Place of residence. Pancreatic cancer is more common in urban than in rural people, regardless of their social status.

Harmful habits( smoking and alcoholism).It is believed that a third of all cases of pancreatic cancer are caused by smoking. It is possible that it is with smoking that a higher incidence of pancreatic cancer in men is associated. And alcohol stimulates the secretory function of the pancreas, creating conditions for the development of the disease.

A diet rich in meat products and fats. There is evidence that the incidence of tumors increases with increasing fat intake. Those who adhere to a diet rich in fruits and vegetables containing retinoids and vitamins are less likely to take risks.

Diabetes. Pancreatic cancer is more often diagnosed in patients with diabetes mellitus. The incidence is clearly associated with the development of diabetes mellitus for 2 years or more before the appearance of the tumor.

Chronic pancreatitis( prolonged inflammation of the pancreas) is associated with an increased risk of cancer of this localization.

Occupational hazard. Some chemicals used in oil refining, pulp and paper, asbestos production, can provoke pancreatic cancer.

Family history. It happens that in some families pancreatic cancer is found in several people. Changes in DNA can lead to an increased risk of various types of cancer.

What changes in health status should you pay attention to if you are at risk? The matter is complicated by the fact that at an early stage this disease is almost not manifested, so people do not seek medical help. In some cases, there is a feeling of heaviness after eating, heartburn, bowel function is disrupted: flatulence, constipation, and occasionally diarrhea. Often there is an aversion to fatty or meat foods.

The first alarming symptom of the disease is most often the pain that occurs in 70-85% of patients. Some patients describe it as a feeling of pressure, raspiraniya or dull constant aching pain, others complain of acute pain in the right hypochondrium or epigastric region.

Sometimes, against the background of stupid permanent pain, there are attacks of extremely strong, intolerable pain, which last from several minutes to several hours. A person takes a forced position, leaning on the back of a chair or bending over a pillow pressed to the stomach. This pose in the form of a hook is quite typical for patients with advanced pancreatic cancer. It is noted that pain often appears or intensifies in the evening or at night, when a person lies on his back, and also after heavy fatty foods and alcohol intake.

Then jaundice develops, which is steadily increasing. At first, the skin has a bright yellow color with a reddish tinge, which is due to accumulating bilirubin. In the future, as oxidation of bilirubin, jaundice acquires a greenish tinge. Jaundice is accompanied by a change in the color of urine and feces. Usually, due to the overlap of the common bile duct with the tumor, the stool becomes light, looks like white clay. If blood is mixed with it, the feces acquire a silvery tinge. The urine, on the contrary, becomes dark, brown in color and resembles a beer in color.

Most patients suffer from severe skin itching, which causes insomnia and increased irritability, often leads to numerous combs, traces of which are visible on the skin.

If you suspect a pancreatic cancer, a special examination is performed. Computer tomography( CT) helps to examine in detail the internal organs, to detect the tumor and to determine the extent of its spread. Ultrasound( ultrasound) can determine the type of tumor formation in the gland.

With endoscopic retrograde cholangiopathy-cretography, ducts leading to the pancreas are examined using a thin flexible tube. Contrast substance introduced into these channels allows to see on the X-rays a narrowing or block, which may indicate cancer. The only accurate method for diagnosing pancreatic cancer is biopsy, when a piece of tissue that is suspicious of a tumor is taken for research. A biopsy is done both during the operation and with a puncture by a thin needle.

The only way to radically treat pancreatic cancer is surgery. As a rule, these operations are complex and difficult to bear by patients. With cancer of the body and tail of the pancreas, its resection is performed with removal of the spleen. In a number of cases, radiation treatment and chemotherapy are additionally carried out.

With untreated pancreas cancer, the prognosis is poor. However, with appropriate treatment, patients live for 5 years or more after detecting this type of cancer. At present, there are no clear recommendations for the prevention of this disease. However, it is prudent to avoid smoking, eat more fruits and vegetables, while animal fats should be limited.

Against the background of the incidence of pancreatitis and diabetes mellitus, cysts and pancreatic fistulas are not diagnosed often. Stone formation in the pancreas is also a rare disease. Nevertheless, these diseases, if not recognized in time, seriously complicate life and significantly worsen health.

Pancreatic cysts are rather difficult to recognize. It happens, they are confused with cysts of kidneys, adrenals and liver. Typically, a patient with pancreatic cysts complains of pain in the right or left hypochondrium and epigastric region, which can be both paroxysmal and permanent, both blunt and sharp. Sometimes the pain is shrouded and given in the back.

Pancreatic cysts are fraught with complications. If the cyst compresses any part of the gastrointestinal tract, the stomach, gall bladder suffers, intestinal obstruction arises. When squeezing the common bile duct cyst, jaundice appears if the portal vein is impaired, ascites develop( fluid accumulation in the abdomen).As with other pancreatic diseases, when a cyst is formed, the patient begins to lose weight, quickly becomes tired, complains of intestinal disorders.

Cysts are both congenital and acquired. Acquired cysts occur as a result of inflammation or trauma to the pancreas, have a tumor or parasitic( infection with echinococcus) nature.

This type of cyst is divided into true and false. True cysts occur as a result of blockage of pancreatic ducts by a tumor or stone or are a consequence of chronic pancreatitis. They usually "love" the head or body of the pancreas and are filled with a transparent liquid in which pancreatic enzymes can be detected. Their inner surface is lined with epithelium.

False cysts are not associated with ducts, their walls form not epithelium, but connective tissue. They are also filled with liquid contents, but with an admixture of not enzymes, but blood. Most often they are formed after acute acute pancreatitis and can reach quite large sizes. The cause of their occurrence may be a trauma to the pancreas. All cysts conceal the danger of suppuration and rupture in case of trauma.

If the cyst is large, then at the examination the doctor manages to feel the compaction in the upper half of the abdomen. The most accurate studies that make it possible to determine that a patient really has a pancreatic cyst are ultrasound and computed tomography. With their help, doctors precisely establish the gland compartment where the cyst is hiding, determine its shape, size and determine what it is full of.

Cysts are removed surgically. If the operation is done in a timely manner, the patient quickly recovers.

Pancreatic fistula is a channel of uneven diameter, the walls of which are formed by fibrous tissue. In the course of the fistula, narrowing or widening of the lumen is often observed. The base of the fistula is associated with one of the major ducts of the pancreas.

There are external fistulas, when the fistula opening opens on the skin, and internal, when the fistula communicates with the hollow organ( stomach, small or large intestine).External fistulas of the pancreas most often occur after an open abdominal trauma or after surgery on the gland, combined with the opening of its ducts. Internal fistulas are usually the result of acute pancreatitis or perforation of the pancreatic cyst.

For external fistula of the pancreas is characterized by the release of pancreatic juice through the external aperture of the fistula. The amount of discharge depends on the type of fistula. With a complete fistula( rare), 1 to 1.5 L of juice is released per day, with incomplete - often a few drops. Depending on how much the pancreas is affected, either pure pancreatic juice or pancreatic juice that contains an admixture of blood and pus is secreted.

Significant loss of pancreatic juice leads.to a sharp deterioration in the patient's condition. Developing dehydration, exhaustion, adynamia, and in severe cases - a coma. Emerging infected pancreatic juice also causes severe irritation of the skin around the fistula.

It is usually easy to recognize external fistulas! The final diagnosis is confirmed by examining the content of pancreatic enzymes in the fistula to be separated. To clarify the diagnosis apply a special study - fistulography. If the fistulography contrast fills the pancreatic ducts, the diagnosis is beyond doubt.

Incomplete fistulas are usually closed under the influence of conservative treatment, which includes activities aimed at improving the general condition, combating depletion and dehydration. To reduce the secretory activity of the gland appoint atropine, ephedrine, pancreatin, vikalin, pentoksil, irrigation of the duodenum with hydrochloric acid, cortisone and others. In recent years, trypsin inactivator is used - trasilene. Iodine preparations( iodolpol) are injected into the fistulous course, X-ray therapy and irradiation with radium can be used.

Local treatment consists in careful care of the skin around the fistula to prevent inflammation. In the lumen of the fistula, drainage is also introduced, through which the contents are pumped out and the fistula is washed with a weak solution of lactic acid.

In order for incomplete fistulas to close more quickly, doctors also recommend adhering to a special diet rich in proteins and poor carbohydrates. With this diet, the secretion of pancreatic juice is limited.

With full fistulas, surgical treatment is indicated. The most common types of surgery are: excision of the fistula, suturing of the fistula formed into the stomach or small intestine, excision of the fistula with simultaneous removal of the distally affected pancreas.

Sometimes, after a pancreatitis in the pancreas, namely in pancreatic ducts, stones or, as they are called, concrements are formed. Usually one or two stones grow, but sometimes a whole scattering is found on the X-ray. These light gray or light yellow pebbles consist mainly of calcium, and their magnitude ranges from a grain of sand to a hazelnut. If you do not take measures in time, the stones can clog the pancreatic ducts, which causes inflammation, sclerosis and leads to body atrophy.

Usually a patient suffering from stones in the pancreas complains of paroxysmal pains at the top of the abdomen or the left hypochondrium. They can be shrouded, given in the back and left scapula, accompanied by nausea and vomiting. Sometimes pain can not be alleviated even with the help of narcotic painkillers. The muscles of the abdomen are straining, the examination becomes painful.

Stones in the pancreas( pancreolithiasis) are dangerous because they can lead to a malfunction in the pancreas and even the development of diabetes mellitus. Sometimes jaundice develops, cysts and abscesses of the pancreas are formed. In some cases, severe painful attacks with vomiting and fever finish result in the release of the stone into the intestine.

Diagnosis of this disease is difficult to put. Usually, stones can be seen with a survey radiography. But sometimes they are non-radiocontrast, and then they are detected with the help of retrograde pancreatocholangiography. To clarify exactly where the stones are, the patient is prescribed ultrasound and computer tomography. In rare cases, the doctor goes to a diagnostic laparotomy.

If pain attacks become frequent, complications develop, stones must be surgically removed, sometimes even with part of the pancreas.

Pancreatic damage in peacetime is relatively rare. This can occur when the trunk is squeezed or when it is hit hard with a blunt object in the epigastric region, as well as during operations on the stomach, duodenum, liver. In this case, between the capsule of the gland and the body itself, blood accumulation( hematoma) can occur, sometimes a capsule or large ducts are damaged, and a organ breakage also occurs.

As a rule, with minor closed trauma, there is a slight hemorrhage in the gland and the condition of the victim does not cause concern. The operation in this case is not required. But there are closed injuries, in which the capsule or even the gland itself is torn. An organ can come off. In this case, internal bleeding begins, peritonitis( inflammation of the peritoneum) may develop. The patient complains of severe pain in the abdomen, he rushes in bed. The pulse speeds up to 120 beats per minute( at a rate of 60-80 strokes), blood pressure drops, the temperature rises, the tongue becomes dry. The muscles of the abdomen are straining, the gases cease to flow.

An open trauma to the pancreas usually occurs as a result of knife or gunshot wounds. In this case, pancreatic juice can cause necrosis of the gland and nearby organs.

If the injury is closed, it is difficult to establish that the pancreas is damaged. However, various tests allow the diagnosis. When the blood sugar level increases, the activity of the enzyme amylase in the blood and urine, this indicates a violation of the pancreas. Sometimes, in order to clarify the diagnosis, a laparoscopy is performed. In severe cases of both open and closed traumas of the pancreas, one can not do without surgery - sutures are made on the glandular capsule, stopping bleeding and draining the abdominal cavity.