Acute pancreatitis – treatment of disease. Symptoms and prevention of diseases of acute pancreatitis

Острый панкреатит – что это за болезнь? Acute pancreatitis is an inflammatory disease of the pancreas burst, increasingly aseptic, marker type, due to nekrobiozom pankreatocitov, as well as enzyme autoagressiej with subsequent dystrophy and necrosis of the gland and the secondary infection.

Mortality in this disease is high enough, regardless of the existence of a large number of modern methods of treatment, and is about 10-15% (from destructive forms- 40-70%).

Острый панкреатит – Причины возникновения

Acute pancreatitis is a disease polijetiologichnym. Among the main etiological factors include:

• alcohol abuse, party surrogates alcohol;
• pathology of biliary system (swelling or spasm of the sphincter of Oddi, cholelithiasis, congenital anomalies of the biliary tract, papillit, etc.);
• uniform metabolic or fatty food;
• surgery (pylorus preserving gastrectomy, gastrectomy, distal gastrectomy, etc.);
• pancreatic trauma;
• the shock of various etiologies (cardiogenic, anaphylactic, septic, hypovolemic, etc.);
• infectious agents (Coxsackie virus, cytomegalovirus, mumps virus, virus hepatitis, Mycoplasma, askaridы, Legionella, etc.);
• acceptance of certain medications (tiazidы, merkaptopurin, furosemid, hormones, Erythromycin, Salicylates, etc.);
• violations of hormonal (pregnancy, hyperparathyroidism, etc.);
• genetic factors (gene mutation, responsible for the activation of trypsinogen);
• Autoimmune mechanisms;
• Neoplasms of the pancreas and papilla;
• poison serpent, Scorpions and insects.

Symptoms of acute pancreatitis

For acute pancreatitis is characterized by sudden onset of (often after receiving large amounts of oily, acute, fried food or alcohol). Characterized by a triad of symptoms (triad-Mondor):

• epigastric pain, in the left or right hypochondrium, zoster nature, irradiirujushhaja in the back;
• vomiting, not bringing relief;
• flatulence (bloated feeling).

Body temperature first subfebrilnaya, However, when the development of pancreatic necrosis is a hectic nature. When massive pankreonekroze may experience shortness of breath, cyanosis, tachycardia, arterial hypotension until collapse, confusion.

Острый панкреатит – Диагностика

• physical examination;
• biochemical blood analysis (amylase, lipase, bilirubin, trypsin, transaminases and others.);
• biochemical analysis of urine (amylase);
• ULTRASONOGRAPHY of the pancreas;
• radiography of abdominal cavity organs;
• computed tomography of the abdomen;
• Magnetic resonance imaging;
• esophagogastroduodenoscopy (Endoscopic examination of the upper gastrointestinal tract);
• angiography;
• laparoscopic method.

Острый панкреатит – Классификация

Depending on the etiology of acute pancreatitis are divided into biliary and nebiliarnyj. Depending on the severity of the current-netjazhjolyj, heavy and lightning (extremely heavy) acute pancreatitis.

Given the form of acute inflammation of the following varieties of pancreatitis:

• acute interstitial (otjochnyj) pancreatitis;
• acute pancreatic necrosis (necrotizing pancreatitis).

Last, in turn, You can split by the presence of infection (infected or aseptic) and prevalence, namely:

• limited pankreonekros (necrosis of less 30% the gland parenchyma);
• common (30-50% necrosis of parenchyma);
• total (or subtotal'no-total) pancreatonecrosis-struck more than half of the pancreatic parenchyma.

Острый панкреатит – Действия пациента

If you experience the above symptoms you must urgently seek specialized medical care.

Treatment of acute pancreatitis

Patients with acute pancreatitis should be urgently admitted to hospital. Immediately conducted antishock therapy, adequate analgesia, respiratory and hemodynamic support, suppress the secretion of pancreatic function, antibiotic therapy. When heavy and very heavy during acute pancreatitis usually shown surgical intervention.

Острый панкреатит – Осложнения

Complicated acute pancreatitis may enzymatic peritonitis, biliarnaja hypertension, acute aseptic parapankreaticheskie fluid, acute bleeding, enzymatic cholecystitis, gnoynыy peritonitis, abdominal abscesses, Phlegmon retroperitoneal fiber, sequesters, CVIS, sepsis, shock, DIC, respiratory, heart failure, Kidney and/or liver failure, severe metabolic disturbances.

Prevention of acute pancreatitis

Prevention includes adherence to treatment and rationalization of nutrition, abstinence from drinking excessive amounts of alcohol, timely treatment of diseases of the gastrointestinal tract.