Contents
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, the gland’s own juice is digested. Activation of interstitial enzymes contributes to the progression of pathological processes, foci of fatty pancreatic necrosis appear.
After the splitting of fatty acids, the ratio of acids and alkalis is disturbed and the pH shifts to the acid side, the activation of intracellular trypsinogen, which transforms into trypsin, 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 organ and restoration is already impossible. After the manifestation of obvious symptoms, death can occur instantly.
The causes of this disease are excessive alcohol consumption, overeating, violation of the outflow of enzymes in cholangitis, biliary dyskinesia, calculous cholecystitis.
To provoke necrosis of the pancreas can be misuse of drugs, violation of the dosage. Often acute infectious diseases, stress cause the development of such a pathology. According to the distribution of pancreatic necrosis is focal and extensive. The process may be sluggish or progress rapidly. According to the type of pathological process, pancreatic necrosis is divided into edematous, hemorrhagic, hemostatic, functional and destructive.
In the edematous form, the parenchyma of the organ swells, pressure on pancreocytes 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 the 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. An extensive acute illness affects people who drink alcohol.
Symptoms of pancreatic necrosis
Symptoms – acute pain in the left hypochondrium, encircling nature, spreading below the ribs throughout the body and radiating to the shoulder and shoulder blade 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, lung atelectasis, liver dystrophy, malnutrition, diarrhea.
The diagnosis is accurately established on the basis of complaints, laboratory and instrumental methods of examination. Elevated levels of amylase in the urine and blood, the development of hyperglycemic coma are characteristic of pancreatic necrosis. Ultrasound is performed to assess the echogenicity of the parenchyma and the presence of exudate. Computed and magnetic resonance imaging, laparoscopy, angiography accurately establish the onset of the disease.
Treatment of pancreatic necrosis
Treatment of the disease can be conservative and surgical, it all depends on the pathological changes in the organ. Drug treatment is prescribed by the doctor individually, it can be therapeutic starvation, detoxification, taking antispasmodics, anti-enzymatic drugs and cytotoxic drugs that affect the synthesis of enzymes.
Laparoscopy and laparotomy are surgical procedures.
But they do not always eliminate this phenomenon, so the development of secondary complications is not excluded. People suffering from necrosis of the pancreas can only be cured in a hospital setting. The disease is very severe, the mortality rate for pancreatic necrosis is high.
To save the patient, it is necessary to involve endocrinologists, surgeons, therapists, specialists in echotomography, endoscopy, so that the diagnosis and treatment are comprehensive and effective. Doctors are trying 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.