Causes and symptoms of pancreatic necrosis
The causes of pancreatic necrosis
Pancreatic necrosis is a process that is expressed in tissue death under the influence of various traumatic factors, which are based on acute and chronic inflammation of the pancreas. The development of necrosis occurs if the examination and treatment of the pancreas is delayed.
Under the action of pancreatic enzymes, or, more simply, its own juice, the gland is digested. Activation of interstitial enzymes contributes to the progression of pathological processes, foci of fatty pancreatic necrosis appear.
After the breakdown of fatty acids, the ratio of acids and alkalis is disrupted and the pH shifts to the acidic side, intracellular trypsinogen is activated, which is transformed into trypsin, it activates proteinases that form special proteolytic foci.
Enzymes (elastase) corrode the walls of blood vessels and the connective tissue of the gland, the process of destruction goes beyond the limits of the organ and restoration is already impossible. Death can occur instantly after the manifestation of obvious symptoms.
The causes of this disease are excessive alcohol consumption, overeating, impaired outflow of enzymes in cholangitis, biliary dyskinesia, calculous cholecystitis.
Incorrect use of drugs, violation of dosage can provoke necrosis of the pancreas. Often acute infectious diseases, stress become the cause of the development of such a pathology. In terms of spread, pancreatic necrosis is focal and extensive. The process can be sluggish or progress quickly. By the type of pathological process, pancreatic necrosis is divided into edematous, hemorrhagic, hemostatic, functional and destructive.
With the edematous form, the parenchyma of the organ swells, the pressure on the pancreatocytes increases and microcirculation is disturbed. This is the most favorable form, with timely conservative therapy, treatment is always successful. If untreated, the necrotic process disrupts the release of digestive enzymes from the pancreas, digesting it from the inside.
Then pus enters the abdominal cavity and acute peritonitis develops. In this case, urgent surgical intervention cannot be avoided, otherwise it threatens with sepsis and death for the patient. Widespread acute illness affects people who drink alcohol.
Pancreatic necrosis symptoms
Symptoms are acute pain in the left hypochondrium, encircling in nature, spreading below the ribs throughout the body and extending to the shoulder and scapula like a heart attack. The processes are accompanied by profuse vomiting, flatulence and bloating. The temperature rises, redness or pallor of the skin is noted.
The main symptom is the Gray-Turner symptom - the appearance of cyanotic spots on the sides of the abdominal cavity.
Also characteristic during this period is the tension of the anterior abdominal wall, pain during its palpation. Fluid accumulates in the pericardium and pleural cavity. Chronic disease is complicated by diabetes mellitus, gastrointestinal bleeding, obstructive jaundice, pleurisy, pulmonary atelectasis, liver dystrophy, exhaustion, diarrhea.
The diagnosis is accurately established on the basis of complaints, laboratory and instrumental examination methods. An increased level of amylase in urine and blood, the development of hyperglycemic coma are characteristic of necrosis of the pancreas. Ultrasound examination is performed to assess the echogenicity of the parenchyma and the presence of exudate. Computer and magnetic resonance imaging, laparoscopy, angiography accurately establish the onset of the disease.
Pancreatic necrosis treatment
Treatment of the disease can be conservative and surgical, it all depends on the pathological changes in the organ. Medication is prescribed by the doctor individually, it can be therapeutic fasting, detoxification, taking antispasmodics, antienzyme drugs and cytotoxic drugs that affect the synthesis of enzymes.
Laparoscopy and laparotomy are surgical interventions.
But they do not always eliminate this phenomenon, so the development of secondary complications is not excluded. People suffering from pancreatic necrosis can only be cured in a hospital setting. The disease is very serious, the mortality rate in pancreatic necrosis is high.
To save the patient, it is necessary to involve endocrinologists, surgeons, therapists, echotomography specialists, endoscopy, so that the diagnosis and treatment are comprehensive and effective. Doctors try to use technologies that reduce the number of complications, have a low mortality rate, and eliminate the disability of patients. With productive treatment and adherence to a rational diet, health problems can be avoided.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
