The pancreas is located in the abdominal cavity (approximately the level of the first and second lumbar vertebrae). The organ is located behind the stomach and tightly adjoins it and the duodenum.
If you carry out a projection on the side of the abdominal wall, its location is about 5-10 cm above the navel.
The head of the gland is surrounded by the duodenum, which surrounds it in the shape of a horseshoe. Through the pancreas-duodenal arteries, blood supply to the pancreas is provided.
How does the pancreas hurt?
Pancreatic diseases such as pancreatitis, adenocarcinoma, stones in the excretory ducts, necrosis and diabetes are often found.
The following symptoms indicate pancreatitis - inflammation of the pancreas, as well as damage to it:
- pain in the area under the ribs in the left side,
- increased sweating
- nausea, vomiting,
- yellowness of the skin and eye proteins,
- possibly a shock condition.
With increased pain, the vomiting reflex becomes stronger. Attacks of vomiting may precede the onset of pain. Often, vomiting appears in the morning or as a reaction to a meal, i.e. as a result of stomach cramps. After vomiting, which has a bitter or sour taste, relief comes for a while. Vomiting can be both systematic and appear periodically.
Pancreatic treatment at home
Symptoms of acute pancreatitis include vomiting and abdominal pain, which lasts several days. The same symptoms can signal cholecystitis, appendicitis, intestinal obstruction, or a stomach ulcer. To determine the correct diagnosis, an immediate visit to the doctor is required. Acute pancreatitis is treated only in a hospital setting.
The following folk remedies will help cure pancreatic pain.
A mixture of lemon and garlic
To enhance the effect, drinking the mixture is recommended with a useful infusion. It is prepared as follows: take in equal proportions blueberry, lingonberry, strawberry leaves, corn stigmas, bean pods. One tablespoon of the resulting collection is poured in a thermos with one glass of boiling water and infused overnight. A glass of infusion is divided into three parts and drunk with a garlic mixture. Treatment is carried out for three months.
Parsley milk broth
Groups of medications are used to treat pancreatic diseases.
To reduce the production of enzymes, patients are prescribed "Contrical", "Aprotinin". When an acute attack goes away or with chronic pancreatitis, enzyme therapy is needed to help normalize digestive function. In this case, appoint: "Mezim", "Panzinorm", "Pancreatin", "Festal", "Creon". Their use is contraindicated in allergies to pork protein, since this component is the basis. In childhood, such a reaction can provoke intestinal obstruction, then herbal remedies will come to the rescue: Somilase, Unienzyme, Somilase, they include papain or rice fungus.
In diseases of the pancreas, one cannot resort to self-medication, which can provoke diseases such as diabetes, necrosis, and blood poisoning.
To relieve pain and prevent irritation, medical products in the form of gels or suspensions are used. Their task is to neutralize hydrochloric acid (Fosfalugel, Almagel) or to reduce its production (Omez, Proseptin, Contralock, Omeprazole, Ocid, Gastrozole).
The broadest part of the pancreas of an adult is the head: it reaches a width of 5 cm, a thickness of 1.5-3 cm. The body is the longest part of the body, the width of which is 1.7-2.5 cm. The norm is the length for the tail - up to 3.5 cm and a width of about 1.5 cm.
To identify pathologies in medicine, ultrasound is used, as a result of which the shape and size of the organ are determined, indicating its condition. Other research methods are difficult because the pancreas is deep enough.
The structure of a healthy organ is homogeneous. Minor changes in the size of the head, tail or body can be considered the norm in case of excellent indicators of a blood test for biochemistry.
One of the most important roles of the pancreas in the body is the production of pancreatic juice, which consists of salts, water, enzymes (proenzymes).
Pancreatic enzymes include:
- Trypsin and chymotrypsin (help digest protein)
- Amylase - breaks down carbohydrates,
- Lipase - completes the process of splitting fats that were under the influence of bile from the gallbladder.
The pancreatic juice contains trace elements - acid salts, which provide an alkaline reaction. This neutralizes the acid of food coming from the stomach and helps to absorb carbohydrates.
The secretion of pancreatic juice is in direct connection with food intake. This means that when eating different foods, juice enzymes of different composition and volume are produced.
Causes and signs of pathology
Alcohol abuse viral infections (mumps, hepatitis B),
Chronic pancreatitis can occur for a number of reasons, more about this in the article "Chronic pancreatitis."
Biliary hypertension occurs as a result of blocking the release of bile as a result of the development of obstructive jaundice. The main reason for this condition is tumors and calculi.
According to the prevalence of the process, it can be:
- segmental (with increasing pressure only in the splenic vein),
- total (with a violation in the entire vascular system of the liver).
According to the localization of the blocking reason:
- initial, with minor functional impairments,
- moderate (compensated)
- decompensated with severe manifestations,
- complicated (the development of bleeding and liver failure).
The reasons for the development of this kind of hypertension can be:
- Helminthic invasion (echinococcosis).
- Cicatricial narrowing in the biliary tract.
- Pancreatic inflammation.
- Anomalies in the structure of the biliary tract of an innate nature.
- Benign neoplasms in the area of the head of pancreas.
- The presence of stones.
- Cancer tumor.
- Metastases in the liver.
- How is this manifested
Symptoms of increased pressure in this case do not appear for a long time. Perhaps only the development of general weakness, slight soreness in the epigastric region and the right hypochondrium.
Digestion is sometimes noted. The patient does not consider these signs serious, and does not consult a doctor. Then there is an increase in the spleen with the phenomena of hypersplenism.
In the later stages, a gradually increasing accumulation of fluid in the peritoneal cavity occurs. This phenomenon, which has the name ascites, is practically not removed after taking diuretics. The pains get stronger.
During the examination, the specialist notices an increase in the abdomen, swelling in the distal parts of the lower extremities, expansion of the veins on the front surface of the abdomen, yellowness of the sclera and skin.
With obstructive jaundice, urine becomes dark, and the stool becomes discolored. Scratches are visible on the skin, as the patient experiences severe skin itching.
Gradually, asthenisation occurs (especially with oncological pathology), a decrease or complete lack of appetite.
On palpation, there is an increase in the liver, pain in the region of both hypochondria and in the stomach zone. The addition of inflammation gives an increase in temperature, which remains constant, and does not go away with the appearance of jaundice (unlike viral hepatitis).
At the stage of development of complications, the patient develops bleeding. They appear as a result of damage to the dilated veins in the esophagus, rectum and stomach. A feature of such a symptom is its suddenness and profuse blood loss.
Confirmation of the diagnosis is carried out using ultrasound, duodenography, radioisotope scanning of the liver. In especially severe cases, laparoscopic diagnosis is used.
Help and therapy
Patients with such symptoms should always be in the hospital. With the development of human complications, they are hospitalized in the intensive care unit.
Diet should be rich in carbohydrates and proteins. If symptoms of encephalopathy occur, then protein is not recommended for use in food. In the acute period, food should be taken in small portions and often.
Treatment of biliary hypertension can be conservative if only functional disorders are noted. To assist are used:
- beta-receptor blockers (atenolol),
- nitrates (nitrosorbitol),
- ACE inhibitors (monopril),
- glycoaminoglycans (sulodexide).
- Normalization of fluid and electrolyte balance. This is achieved with the help of intravenous preparations and droppers.
- Forced diuresis to cleanse the body and reduce intoxication syndrome.
- Normalization of the rheological properties of blood.
- With concomitant cholangitis, a course of antibacterial therapy is used. The drugs of choice in this case are cephalosporins.
- The use of drugs to improve blood supply and nutrition of liver cells.
- Decompression of the biliary tract (transhepatic or percutaneous).
Surgical techniques are used in case of increasing symptoms and ineffectiveness of drug therapy. Indications for the operation are the development of ascites, hyperspelinism, severe bleeding from internal organs.
The first step is the operation to eliminate the cause of the syndrome. A tumor or calculus is removed. In case of malignancy in an inoperable stage, palliative treatment is used - chemotherapy and radiation. In some cases, a liver transplant is performed.
The iron is located behind the stomach, lies transversely and in size reaches fifteen centimeters.
A healthy pancreas is pinkish in color.
And if this organ is susceptible to any disease, it becomes gray, dull, loose and tuberous.
The topography of the organ is represented by several anatomical parts:
- The body, which is located in the gyrus of the duodenum,
- The left lobe or gastric lobe, which is adjacent to the lesser curvature of the stomach and reaches the spleen and left kidney,
- The right lobe, or duodenal lobe, which reaches the right kidney.
Diffuse heterogeneity of the pancreas is not an independent disease. In medicine, it is considered as a sign of an anomaly. The diagnosis is made on the basis of an examination of the organ using ultrasound.
Diffuse-heterogeneous pancreas can be an indicator of the presence of various diseases of the pancreas, including pancreatitis.
The pancreas is a fairly large and important organ. It performs a number of important functions in the body, including the development of pancreatic juice, which takes part in the digestion of food. If there are disturbances in the activity of the entire organ, digestive disorders can be observed.
An examination of the pancreas is prescribed if there are problems with it that have already manifested and there are alarming symptoms. If a diffuse heterogeneity of an organ is detected, it is necessary to conduct further studies that will most accurately identify the cause of its occurrence.
One of the most significant reasons is called malnutrition and poor diet, however, these factors most often cause the appearance of a uniform violation of the structure of the organ. The causes of diffuse heterogeneity of the pancreas can be the following:
- Subacute pancreatitis. This condition is a harbinger of acute pancreatitis or a developing exacerbation of the chronic form of the disease. This pathology can occur for a sufficiently long period of time. At the same time, the structure of the gland changes slightly, and the symptoms (usually heaviness in the abdomen, nausea, mild pain) are weak. If you do not follow a diet, the subacute period will turn into acute, which is quite a dangerous and unpleasant disease,
- Chronic pancreatitis. This stage can proceed in different ways. With a mild form of exacerbation is quite rare, about 1-2 times a year. A severe form is characterized by frequent exacerbations with severe pain, rapid weight loss. During remission, changes in ultrasound are not visible, however, during exacerbations of chronic pancreatitis, the structure of the organ is seen as heterogeneous,
- Pancreatic cyst. If the heterogeneity of the organ is caused by cysts, which are cavities in the tissues of the gland filled with fluid, by ultrasound they are defined as formations with reduced echogenicity,
- Tumor. Malignant and benign tumors can also be detected by ultrasound as heterogeneous sections of the structure. Oncological diseases alter the structure of the organ already in the initial stages.
Symptoms of pancreatic diseases are regular nausea, vomiting, heaviness and pain in the abdomen, flatulence, chronic constipation or diarrhea, impaired appetite.
According to existing generally accepted views, all forms of pancreatitis develop as a result of local and general reactions of the body in response to the pathological effects of activated proteolytic and lipolytic pancreatic enzymes.
Among the reasons contributing to the development of pancreatitis, mechanical, neurohumoral and toxic-allergic factors are distinguished.
Mechanical factors include a violation of the outflow of pancreatic juice due to blockade of the ampoule into which the common bile duct and pancreatic duct open. The causes of the blockade can be: • persistent spasm of the sphincter of Oddi due to recurrent biliary colic in gallstone disease, acute cholecystitis, dyskinesia of the duodenum 12 (duodenostasis) and duodenopancreatic reflux,
Among the neurohumoral factors, the most important are impaired fat metabolism and systemic vascular diseases, and among toxic-allergic factors, excessive consumption of alcohol. Drug and food allergies occupy a very modest place among these reasons. These factors are often realized after drinking alcohol, fatty and spicy foods.
Pancreatic necrosis is a process that is expressed in tissue death due to various traumatic factors, which are based on acute and chronic organ inflammation. The development of necrosis occurs if the examination and treatment of the pancreas is delayed.
In some cases, especially with pronounced widespread atherosclerotic vascular lesions in the elderly and senile, sometimes there are thrombosis and pancreatic infarction.
Their cause may be small blood clots and embolism from the left atrium with heart defects, with infectious endocarditis, embolism from atheromatous plaque. It is believed that in these cases, emboli enter the various organs: the kidneys, spleen, liver, etc. It is believed that the treatment of anticoagulants and aortography may be provoking factors in embolism with the contents of atheromatous plaques, since these factors contribute to the separation of the contents from atherosclerotic plaques .
Apoplexy and pancreatic infarction, at least at the beginning of the development of the process, differ from acute hemorrhagic pancreatitis in morphological criteria by their limited, strict focal hemorrhagic process.
The treatment is carried out in the surgical department of the hospital according to the general principles of treatment of acute hemorrhagic pancreatitis.
Pancreatic diseases are described in the video in this article.
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The pancreas is an organ of external and internal secretion. It secretes pancreatic juice into the duodenum. The pancreas and bile ducts develop together with the duodenum, which is manifested in their anatomical and functional unity and interdependence. Often there is a simultaneous disease of these organs.
The pancreas is located retroperitoneally at the level of 1-11 lumbar vertebrae, occupying a transverse position between the duodenum and the gates of the spleen. The body of the pancreas with its front surface adjacent to the back surface of the stomach. These organs are separated from each other by a narrow gap - stuffing bag.
Upper mesenteric vessels pass behind the pancreas at the level of transition of its head into the body. The pancreatic duct (Wirsung duct) is formed from the fusion of small lobular ducts. In the head, the pancreatic duct connects to the accessory duct of the pancreas and then flows into the common bile duct.
The pancreatic parenchyma consists of many lobules, separated from each other by layers of connective tissue. Each lobule consists of epithelial cells forming acini. For a day, iron secretes 1000-1500 ml of pancreatic juice. Among the parenchymal cells of the pancreas, there are special cells that form clusters of 0.1-1 mm in size, called pancreatic islets.
Exocrine pancreatic activity is stimulated by the vagus nerves, hormones of the stomach and duodenum (secretin, pancreosimine). Amylase that breaks down carbohydrates and lipase that breaks down fats are secreted by the pancreas in active form. Proteases - trypsinogen and chymotrypsinogen - are excreted in an inactive form.
They are activated only in the duodenum, where trypsinogen, under the influence of enterokinase, is converted into trypsin, which in turn activates chymotrypsinogen into chymotrypsin. Activation of proteolytic enzymes in the duodenum protects the pancreas from self-digestion. In addition, acinus cells secrete protease inhibitors. Pancreatic duct cells also have defense mechanisms.
The main stimulator of insulin secretion is a food rich in proteins and carbohydrates. The compensatory capabilities of the pancreas are so great that only with the removal of about 80% of its parenchyma, clinical manifestations of insufficiency of its functions (diabetes mellitus, etc.) can appear.
Symptoms of pancreatitis.
This form of the disease is accompanied by characteristic symptomatic manifestations. The inflammatory process leads to malfunctions of the pancreas. Normally, the enzymes in it are stored in an inactive form, and begin to act only after they enter the intestine. However, with the development of a condition such as acute pancreatitis, the enzymes are retained in the pancreas, digesting its own tissues. This condition is very dangerous, as it can cause the development of complications such as:
- pleuropulmonary disorders,
- renal and heart failure,
- cardiovascular failure
- blood clots in the vessels,
- mental disorders caused by intoxication of the body.
Some of these conditions can provoke severe disorders, after which the patient dies. If the inflammatory process does not fade over 2 weeks, additional complications may develop, which acute pancreatitis is so dangerous.
Often there is the formation of abscesses in the abdominal cavity, fistulas, phlegmon. At first, the inflammatory process in the pancreas with pancreatitis is aseptic in nature, but in the future the infection may join. This pathology can cause the development of blood poisoning. Septic lesion often causes death on the background of acute pancreatitis. The inflammatory process can cause malignant transformation in the gland.
The prognosis of survival in this pathological condition largely depends on how affected the organ is. Life expectancy is affected by the success of treatment and adherence to the doctor's recommendations.
This form of the disease affects the prognosis of survival. Chronic pancreatitis leads to intense morphological changes in pancreatic tissue, which increases in size and acquires a dense texture. The fibrous membrane in the chronic form of the disease has signs of sclerosis.
Areas of necrosis are characterized by a characteristic yellow color. With an incision in the parenchyma, abundant growths of fibrous tissue are distinguished, characterized by an underlined lobed pattern. In some parts of the organ, the ducts are unevenly narrowed, in some places very dilated. This contributes to the appearance of a progressive malfunction of the pancreas in a condition such as chronic pancreatitis, and significantly worsens the prognosis. Complications that appear against the background of this form of the disease are deadly dangerous, including:
- pancreatic ascites,
- portal hypertension
- phlegmon in retroperitoneal space, etc.
The epithelial lining in such pseudocysts is absent. In the future, this content may be affected by pathogenic microflora. It acquires a characteristic gray-green color. The substance has an extremely unpleasant odor. Along the ducts, small retention cysts can be detected. Some people die precisely because of the destruction of such formations.
The more often chronic pancreatitis is accompanied by periods of exacerbations, the lower the patient's life expectancy.
All tissues of this organ are involved in the pathological process: vascular bed, islet epithelium, acini, duct tissue, nerve apparatus, interstitial tissue. In chronic pancreatitis, calcareous deposits in the organ may form. The mass of functional parenchyma is reduced. In severe cases, this tissue may be completely absent.
As the chronic process progresses, glandular tissue atrophy and organ deformation are observed. Accompanied by these changes, pancreatitis becomes a cause of digestion and the production of vital hormones, leading to a fatal outcome. Accurate prediction of the life expectancy of a patient with pancreatitis is impossible, since if the treatment is comprehensive and the patient follows the doctor's recommendations, abandoning bad habits, the prognosis may be favorable.
Constipation, bloating, digestive upset, heaviness after eating, discomfort in the stomach - these are the first bells in which you need to pay attention to the stomach and pancreas.
In acute pancreatitis, there is a violation of the free outflow of pancreatic juice, leading to self-digestion of the gland by its own enzymes. This disease is characterized by a sharp pain syndrome. Pain in acute pancreatitis occurs in the left abdomen, after a while acquires a girdling character, accompanied by nausea, vomiting.
Due to intoxication, dehydration (frequent vomiting), the condition of patients can quickly become severe: blood pressure drops, consciousness is impaired. Collapse and shock may develop. This disease is considered an emergency in surgery, and it requires an urgent examination by a surgeon and hospitalization in a surgical hospital.
At the same time, the patient can “endure” a mild attack, which, of course, should not be done, because without treatment he can go into chronic pancreatitis, and this is incurable.
During chronic pancreatitis, two periods are distinguished: the initial and the period of severe damage to the pancreas. In the initial period (lasting about 10 years), the main symptom is pain. The pain is localized mainly in the upper and middle abdomen, the left half of the chest, in the region of the heart (as with coronary heart disease) in the left lumbar region (resembles renal colic), can spread around the circumference of the body, be encircled, decrease in sitting position, with torso forward, often occurs 15-20 minutes after eating. An attack in a patient with chronic pancreatitis is classified as acute pancreatitis.
Excessive, greasy, fried, smoked foods, alcohol and carbonated drinks, chocolate, coffee, cocoa provoke pain. Pain with pancreatitis is accompanied by dyspeptic symptoms - prolonged nausea, vomiting, which does not bring relief, bloating, loose stools. Dyspeptic symptoms are not always observed and have a concomitant character, are easily stopped during treatment. Exocrine pancreatic function, as a rule, remains intact.
With the long-term existence of chronic pancreatitis, structural transformation of the pancreatic tissue occurs, its ability to produce enzymes and hormones decreases, and secretory insufficiency forms. The pains become less pronounced, and more often they may be absent altogether. Dyspeptic syndrome predominates in the clinical picture, exocrine pancreatic insufficiency develops, manifested by malabsorption and maldigestion syndromes.
Maldigestion is a violation of the digestion of food to the components necessary for absorption. Malabsorption is a violation of the mechanism of absorption in the small intestine. The leading symptom is a mushy stool 2-3 times a day or more often, “large pancreatic stool” (copious, fetid, oily).
Bloating is typical as a result of an accumulation of gases in the intestines. Weight loss occurs. Signs of hypovitaminosis appear: loss of vision at dusk, pigmentation disorder (vitamin A deficiency), gum bleeding (vitamin K and C deficiency), conjunctivitis, stomatitis, skin itching (vitamin B deficiency), anemia (vitamin B12 and folic acid).
Impaired calcium absorption leads to convulsions, bone pain (osteoporosis). Pancreatic endocrine insufficiency develops. There are episodes of hypoglycemia (lowering blood sugar) with characteristic weakness, neuropsychic arousal, cold sweat, trembling in the body. Pancreatogenic diabetes mellitus further develops. Dry skin, thirst is noted.
One of the most frequent combinations in the practice of a gastroenterologist is a combination of chronic pancreatitis and gastroesophageal reflux disease (GERD), and this also imposes its symptoms, and often this combination occurs against the background of obesity.
If you suspect an attack of pancreatitis as a first aid - rest, sitting position with your knees pressed to your chest, severe starvation with a quarter cup of water every 30 minutes - an hour, put an ice bubble on the pancreas from the back. Superficial breathing will help relieve an attack.
Painkillers and anti-inflammatory drugs should not be taken, this will greatly complicate the diagnosis. Enzyme preparations are also contraindicated. To alleviate the condition of the patient will help 0.8 mg but shpy or drotaverine hydrochloride in a similar dosage, if possible, it is better to do an intramuscular injection of a solution of papaverine 2 ml, you can replace the drug with a solution of shpy. And nitroglycerin under the tongue, well, suddenly it’s not pancreatitis, but myocardial infarction.
Changes in the pancreas are considered as a reaction to primary necrosis and necrobiosis of acinus cells under the influence of their own lipolytic and proteolytic enzymes. Around the foci of necrosis, demarcation inflammation develops with an allergic (hyperergic) vascular reaction, pancreatic edema, an increase in its volume, which is considered as an edematous form of pancreatitis. In most patients, the development of the pathological process stops at this stage
For various origins, pancreatic epithelial tissue is replaced by connective tissue, followed by the development of fibrosis and sclerosis, which can lead to a decrease or increase in the size of the pancreas. A special place is occupied by calculous (calcifying) pancreatitis, in which calcium salts are deposited in the pancreatic tissue or in the lumen of the excretory ducts (wirsungolithiasis). When clogging its small excretory ducts due to an inflammatory or sclerotic process, cysts form in some patients.
Various forms of acute pancreatitis are classified according to clinical and morphological characteristics.
Four clinical and morphological forms of chronic pancreatitis are distinguished.
• chronic inductive,
• calculous (including virsungolithiasis).
Diagnosis of acute pancreatitis is based on a survey (the appearance of sharp abdominal pain after a heavy meal, alcohol, exacerbation of background diseases), data from objective and laboratory studies. Significant help in the diagnosis is provided by ultrasound, which allows you to establish the factors of occurrence (cholecyst - and choledocholithiasis), the severity of morphological changes in the pancreas and the course of the disease, accompanying complications of the disease. The accuracy of the diagnosis of cholecystitis and impaired outflow of bile during ultrasound examination reaches 92-98%. Signs of pancreatic edema are an increase in its volume and a decrease in the degree of reflection of the signal.
Diagnosis of chronic pancreatitis is based on patient complaints, medical history, physical, laboratory and instrumental methods of research. With an exacerbation of the disease and a violation of the outflow of pancreatic juice (more often with virsungolithiasis), an increase in the level of amylase, lipase and trypsin in the blood and amylase in the urine is noted. With primary chronic pancreatitis or a chronic recurring form of the disease in the remission phase, the concentration of pancreatic enzymes in the blood and urine is usually not changed, therefore, in these situations, these samples have no diagnostic value.
The treatment program for acute pancreatitis should be built taking into account the cause of the disease, its severity and clinical course. The patient needs the supervision of a surgeon, therapist and intensive care specialist (resuscitator), who together solve the complex issues of his treatment. The treatment program includes basic therapy, inhibition of enzyme secretion, prevention of autolysis of gland tissue and the development of complications, elimination of the factor of occurrence, treatment of complications and, finally, surgical intervention.
The main treatment for uncomplicated chronic pancreatitis is conservative. A diet is prescribed with the exception of fatty, fried, salty, spicy foods (pepper, garlic, vinegar, etc.).
Acute Pancreatitis Video
Among the detritus of foci of necrosis, clumps of calcium soaps, crystals of fatty acids are visible. Around the pancreas, a dense tumor-like infiltrate develops, in which the stomach and transverse colon are involved. A serous, turbid inflammatory fluid appears in the abdominal cavity. With hemorrhagic pancreatic necrosis, the pancreas is moderately enlarged, dense. Its color, due to the abundance of hemorrhages in the parenchyma of the gland and in the surrounding tissues, turns purple-black.
The section reveals the alternation of foci of dark red color with areas of unchanged parenchyma. The pancreatic tissue is full-blooded, with foci of hemorrhage around small vessels. A significant amount of hemorrhagic exudate is found in the abdominal cavity. Visceral and parietal peritoneum are covered with a dull coating in connection with the development of aseptic peritonitis. In the future, as the disease progresses, the pancreas undergoes necrosis in large areas.
With hemorrhagic diffuse focal pancreatic necrosis, complete or almost complete necrosis of the pancreas usually occurs. In the event of the patient's survival, the dead areas are subsequently rejected, and upon infection, their suppuration with the formation of parapancreatic and retroperitoneal abscesses. In the late period, false pancreatic cysts form.
Thus, the abortive form of focal pancreatic necrosis can be called edematous, or interstitial, pancreatitis. With progressive pancreatitis, in the case of self-destruction of the pancreas, predominantly lipolytic enzymes develop fatty pancreatic necrosis. Under the influence of mainly proteolytic enzymes, rapidly progressing hemorrhagic pancreatic necrosis develops with the formation of extensive edema in the retroperitoneal tissue and the appearance of hemorrhagic effusion in the abdominal cavity (pancreatogenic aseptic peritonitis).
In some cases, mixed forms of pancreatitis are observed: hemorrhagic pancreatitis with foci of fatty necrosis and fatty pancreatic necrosis with hemorrhages. Depending on the prevalence of the process, local (focal), subtotal and total pancreatitis are distinguished. According to the clinical course, the process is abortive and progressive.
The clinical symptoms of acute pancreatitis depend on the morphological form of pancreatitis, the period of development and the severity of the disease. In the initial period of the disease (1-3 days), both with edematous (abortive) form of pancreatitis and with pancreatic necrosis, i.e. progressive pancreatitis, patients complain of sharp pains in the epigastric region (upper abdomen), girdle pains, nausea, repeated vomiting. Pain is often localized in the left half of the epigastrium, in the back, and the right hypochondrium.
There is no clear connection between pain and the localization of the process in the pancreas. The shingles of pain are most common. The intensity of the pain usually depends on the severity of the changes in the pancreas. More often severe and very strong pains are observed. Sometimes they are accompanied by a collaptoid state. The pulse is usually quickened. Blood pressure is normal or slightly elevated for a short period.
When examining the abdomen, pain is noted in the epigastric region and the left hypochondrium. There is no tension in the abdominal muscles. Only sometimes they notice their pain in the area of the projection of the pancreas on the anterior abdominal wall (Kerth symptom). Palpation in the left rib-vertebral angle (projection of the pancreatic tail) is often painful (Mayo-Robson symptom).
Already in the early stages, attenuation of peristaltic noise is detected. With fatty pancreatic necrosis, a post-necrotic infiltrate is formed early, which can be determined in the epigastric region during palpation. In this regard, patients cannot clearly test the pulsation of the aorta (Voskresensky symptom). Paresis and distention of the transverse colon also contribute to this.
When examining the abdomen, some bloating is noted. Tapping determines high tympanitis. However, with the appearance of effusion in the abdominal cavity, dullness of sound occurs in the flat parts of the abdomen, which is more easily detected in the patient’s position on the side. The skin of the abdomen with severe pancreatitis sometimes has a marble tint.
These spots can also be observed with bleeding in the abdominal cavity during ectopic pregnancy, with gangrene of the small intestine. In severe pancreatitis, tapping and listening can reveal reactive pleurisy, which appears relatively early. At the same time, a number of patients develop serous-hemorrhagic peritonitis and shock phenomena, more characteristic of hemorrhagic pancreatitis.
With the loss of fluid with vomiting, its rejection in the edematous tissues of the peritoneum, retroperitoneal tissue, in the root of the mesentery of the intestine and other tissues, it increases to 1.0-1.5. Clinically, shock is manifested by pallor of the skin and mucous membranes, increased sweating, cyanosis of the extremities, a frequent filiform pulse, veins that have fallen, a decrease in the volume of circulating blood, central venous pressure, and cardiac output and cardiac volumes.
Functional disorders of the liver are manifested by icteric coloration of the skin, liver enlargement, blood tests reveal an increase in bilirubin, a decrease in protein, as well as an increase in the number of leukocytes and ESR, acidosis, hyperkalemia, a decrease in Ca, indicating the progression of fatty necrosis, are noted.
There is no strict correspondence between serum amylase and lipase levels and the severity of pancreatitis. It should be borne in mind that an increase in the activity of amylase and lipase can also be observed with renal failure due to a decrease in the excretion of these enzymes in the urine, during ulcer perforation, intestinal obstruction (decreased absorption from the small intestine), acute cholecystitis (a concomitant pancreatic reaction).
A more specific study is the determination of serum trypsin, alpha-chymotrypsin, elastase, and especially phospholipase Az, which plays a key role in the development of hemorrhagic pancreatic necrosis. However, the complexity of their determination restrains the widespread use of these methods.
X-ray examination is less informative. It sometimes allows you to identify radiopaque calculi in the bile ducts, in the pancreatic duct, a change in the location of the stomach and duodenum during volumetric processes in the pancreas. X-ray examination is important for detecting paralytic ileus, effusion in the pleural cavity, disk-shaped atelectasis of the lung, which often accompany acute pancreatitis. A study of the stomach and intestines with a contrast agent in the acute period of pancreatitis is contraindicated.
Computed tomography complements ultrasound. It allows you to more clearly identify foci of necrosis, changes in parapancreatic fiber, "paths of necrosis" outside the pancreas, as well as complications in the form of abscesses and cysts. Ultrasound is easier to use to monitor the course of the disease.
Esophagogastroduodenoscopy is not very important for the diagnosis of pancreatitis. Indications for it occur with gastrointestinal bleeding against pancreatitis. Retrograde choledochopancreatography in acute pancreatitis is contraindicated, with the exception of cases of pinching the calculus in the ampoule, when papillotomy and its removal are required.
Laparoscopy is used for an unclear diagnosis, if necessary, a laparoscopic drainage installation for the treatment of acute pancreatitis. To take peritoneal exudate and conduct diagnostic lavage, you can use the introduction of a catheter into the abdominal cavity through a puncture in the abdominal wall. Electrocardiography is necessary in all cases, both for differential diagnosis with acute myocardial infarction, and for assessing the state of cardiac activity in the course of the disease.
Differential diagnosis should be carried out primarily with thrombosis of mesenteric vessels (intestinal vessels), since sudden sharp pains, a shock state with a soft stomach and normal body temperature can resemble acute pancreatitis. Paralytic bowel obstruction and peritonitis are found in both diseases.
According to clinical data, myocardial infarction is difficult to differentiate from acute pancreatitis, since ECG changes typical of acute myocardial infarction occur in the acute phase of pancreatitis. As in the case of mesenteric infarction of the intestine, and in myocardial infarction, ultrasound helps to differentiate these diseases. With an unclear diagnosis, it is advisable to carry out arteriography of the vessels of the abdominal cavity.
Acute cholecystitis and its complications can be relatively easily distinguished by the typical clinical picture and ultrasound symptoms. Acute pancreatitis has to be differentiated from perforated ulcer, strangulation of small bowel obstruction, aortic aneurysm, renal colic.
Diagnosis of pancreatitis.
For abdominal pain, be sure to call a doctor. Acute pancreatitis can be confused with other life-threatening diseases, and even in severe cases it is deadly.
1. Transabdominal ultrasound (ultrasound). It determines an increase in the size of the pancreas, calcifications in the tissues, fuzzy and uneven contours, heterogeneity of the structure, change in echogenicity, the presence of cysts, and expansion of the ducts. The sensitivity of ultrasound in the diagnosis of pancreatitis is 80-85%.
2. Computed tomography (CT) and magnetic resonance imaging (MRI) - reveal an increase in the pancreas, detect calcification, pseudocysts, determine the expansion of the ducts, reveal lesions of neighboring organs, malignant neoplasms.
3. ERCP - endoscopic retrograde cholangiopancreatography. Currently plays one of the leading roles in the diagnosis of pancreatitis. The sensitivity of this method is 93-100%.
1. Determination of fecal pancreatic elastase -1. This method determines only human elastase, therefore, the test results are not affected by enzyme replacement therapy. It is the "gold standard" for the diagnosis of chronic pancreatitis. 2. General blood test - there are signs of inflammation, anemia. 3.
In the diagnosis of pancreatitis, the leading role belongs to the specialist - physician therapist or gastroenterologist. Only they are able to choose diagnostic methods, their sequence for each individual patient in order to quickly, accurately and with minimal costs to establish the correct diagnosis.
1. Gastroenterologist, to select treatment tactics. 2. Surgeon, with a long-term current pain syndrome, the development of complications. 3. Endocrinologist, with the development of diabetes. 4. Cardiologist to exclude pathology of the cardiovascular system.
Acute pancreatitis is characterized by the development of edema of the pancreas (edematous pancreatitis) or primarily aseptic pancreatic necrosis (destructive pancreatitis), followed by an inflammatory reaction. Acute destructive pancreatitis has a phase course, and each of its phases corresponds to a specific clinical form. The tactics of diagnosis and treatment of the patient depends on this.
Phase I is enzymatic, the first five days of the disease, during this period there is the formation of pancreatic necrosis of various lengths, the development of endotoxemia (the average duration of hyperfermentemia is 5 days), and some patients have multiple organ failure and endotoxin shock. The maximum period for the formation of pancreatic necrosis is three days, after this period it does not progress further.
Severe acute pancreatitis. The frequency of occurrence is 5%, mortality - 50-60%. The morphological substrate of severe acute pancreatitis is widespread pancreatic necrosis (large focal and total subtotal), which corresponds to severe endotoxemia. Severe acute pancreatitis. The frequency of occurrence is 95%, mortality is 2-3%.
Pancreatic necrosis in this form of acute pancreatitis either does not form (edema of the pancreas), or is limited and does not spread widely (focal pancreatic necrosis - up to 1.0 cm). Mild acute pancreatitis is accompanied by endotoxemia, the severity of which does not reach a severe degree.
Phase II - reactive (2nd week of the disease), characterized by the reaction of the body to the formed foci of necrosis (both in the pancreas and in the parapancreatic tissue). The clinical form of this phase is peripancreatic infiltrate.
Phase III - melting and sequestration (starts from the 3rd week of the disease, can last several months). Sequestries in the pancreas and retroperitoneal tissue begin to form from the 14th day from the onset of the disease. There are two possible variants of the course of this phase: 1. aseptic melting and sequestration - sterile pancreatic necrosis,
characterized by the formation of post-necrotic cysts and fistulas, 2. septic melting and sequestration - infected pancreatic necrosis and necrosis of parapancreatic tissue with further development of purulent complications. The clinical form of this phase of the disease is purulent-necrotic parapancreatitis and its own complications (purulent-necrotic sagging, abscesses of the retroperitoneal space and abdominal cavity, purulent omentobursitis, purulent peritonitis, arrosion and gastrointestinal bleeding, digestive fistulas, sepsis, etc.) .
Patients with a diagnosis of acute pancreatitis should, if possible, be referred to multidisciplinary hospitals.
As a rule, it is carried out in a reception or emergency department.
1) The basis for establishing a diagnosis of acute pancreatitis (after exclusion of another surgical pathology) is a combination of at least two of the following identified signs: a) a typical clinical picture (intense necupated spasmolytic pains of herpes zoster, indomitable vomiting, bloating,
drinking alcohol, spicy food or having a history of cholelithiasis, etc.), b) ultrasound (increase in size, decreased echogenicity, vague contours of the pancreas, the presence of free fluid in the abdominal cavity), c) laboratory parameters (hyperamylasemia, hyperamilazuria), d) high activity of amylase enzymatic exudate (2-3 times higher than the activity of blood amylase) obtained by laparocentesis,
2) In parallel with the diagnosis of acute pancreatitis, it is necessary to determine the severity of the disease (severe or mild). Most important is the early detection of severe pancreatitis, the results of the treatment of which are largely determined by the timing of its onset. The signs characteristic of severe acute pancreatitis are as follows: a) clinical: - peritoneal syndrome,
- unstable hemodynamics - tachy- ( The pancreas in a healthy person during examination by ultrasound shows a homogeneous structure. All faces are clear and have a uniform size and the same brightness - echogenicity. Any changes in the studied organ that differ from the norm are called an inhomogeneous structure. When the term is diffuse in the description of the result, this means a uniform distribution of deviations throughout the organ. Ultrasound allows you to determine how pronounced the heterogeneous echostructure of the pancreas is. It can be lowered, increased or completely absent. During the examination, the doctor must identify the degree of pain of the patient. If there is pain, inflammatory processes occur in the pancreas. This symptomatology may indicate various types of pathologies. The occurrence of diffuse heterogeneity of the pancreatic structure is only a statement of a violation of the organ's activity, and not a diagnosis of a specific disease. Such changes can be detected in various cases, the appearance of which is influenced by many circumstances. Important. To make a competent diagnosis, the doctor prescribes additional examinations and tests. Heterogeneous changes in the structure of the pancreas occur under the influence of various factors. Any deviation from the norm is a dangerous sign. To make an accurate diagnosis and prescribe the right treatment, it is important to understand the possible causes of disruption of the organ. These include the following list:
The heterogeneous structure of the pancreas: what is it
Causes of diffuse pancreatic changes
The pancreas in a healthy person during examination by ultrasound shows a homogeneous structure. All faces are clear and have a uniform size and the same brightness - echogenicity. Any changes in the studied organ that differ from the norm are called an inhomogeneous structure. When the term is diffuse in the description of the result, this means a uniform distribution of deviations throughout the organ.
Ultrasound allows you to determine how pronounced the heterogeneous echostructure of the pancreas is. It can be lowered, increased or completely absent. During the examination, the doctor must identify the degree of pain of the patient. If there is pain, inflammatory processes occur in the pancreas. This symptomatology may indicate various types of pathologies.
The occurrence of diffuse heterogeneity of the pancreatic structure is only a statement of a violation of the organ's activity, and not a diagnosis of a specific disease. Such changes can be detected in various cases, the appearance of which is influenced by many circumstances.
Important. To make a competent diagnosis, the doctor prescribes additional examinations and tests.
Heterogeneous changes in the structure of the pancreas occur under the influence of various factors. Any deviation from the norm is a dangerous sign. To make an accurate diagnosis and prescribe the right treatment, it is important to understand the possible causes of disruption of the organ. These include the following list:
Some of the reasons are not amenable to self-correction, and seek help from a doctor. But on some of the factors in which the pancreas can become diffusely heterogeneous, the patient is able to influence and eliminate them.
The most common cause of changes in an organ is malnutrition. An unbalanced diet can significantly damage the pancreas. Those who already have problems with this body, it is better to refrain from salty, spicy, sweet, smoked dishes, and add more low-calorie and healthy foods to your diet.
Addiction to alcohol and tobacco also causes pancreatic problems. For some people, one cigarette or one glass of wine is enough to cause changes in the organ that will lead to inflammatory processes.
Important. This is due to the increased susceptibility of the human endocrine system to the slightest negative effects.
The effects of stress on pancreatic health can also be controlled and corrected. In most cases, the pancreas is brought into a state of diffuse and heterogeneous change by psychological trauma and stress arising at work or at home, which leads to a malfunction of the hormonal background and problems with the endocrine system.
Possible diseases with a diffusely heterogeneous pancreas structure and their symptoms
The heterogeneity of the pancreas is accompanied by the following symptoms: stool disorders, nausea, decreased or lack of appetite, etc.
Violations of the homogeneity of the structure of the pancreas can be signs of the following diseases:
- Pancreatitis in the acute phase, in which the death of inflamed tissue occurs. This leads to intoxication of the body and dysfunction of the process of secretion of gastric juice. On ultrasound, inflammation is characterized by a heterogeneous structure and an increased organ size with a pronounced color. The obvious symptoms of the disease are severe pain, vomiting and low blood pressure.
- Chronic pancreatitis. On ultrasound, the picture will be presented in the form of an inhomogeneous structure with moderate organ sizes and reduced brightness. The disease proceeds for a long time in several stages. At the beginning of the disease, due to damage, the gland swells, and after a while the time decreases. After reduction, the pancreas elasticity is lost and the process of enzyme production is disrupted. With exacerbation, pain in the patient is localized on the left side of the abdominal cavity.
- Lipomatosis The term means an irreversible age-related pathology. During the aging process, the size of the pancreas decreases, and its lack is compensated by fat. Most often, this condition can only be diagnosed with ultrasound, since it is asymptomatic. Lymphomatosis can be caused by diabetes or is transmitted at the gene level.
After passing the examinations and making a diagnosis, the doctor proceeds to treatment. It is carried out stationary or at home. It all depends on the condition of the patient and the course of the disease. Drug therapy necessarily includes a course of enzymes. The duration of administration of drugs is regulated depending on the severity of the disease.
Important. If the patient has pain and vomiting, painkillers and antiemetics are selected.
Therapy also involves strict adherence to the diet and the exclusion of harmful foods from the diet. With the disease, the use of:
- alcohol and tobacco products,
- fried, smoked, salty dishes,
- high protein foods
- coffee and strong teas,
- sweets: chocolate, cakes.
Proper, timely treatment and adherence to the recommended diet will accelerate the onset of remission. Otherwise, inflammation of the pancreas over time will lead to complications: abscess, oncology, bleeding, stenosis, pleurisy, pneumonia.
Causes of organ parenchyma changes
The pancreas is a vital organ that performs exogenous (digestive enzymes) and endogenous (production of insulin and glucagon) function.
The organ has a complex structure and consists of alveolar glands. The exocrine part is represented by a large network of excretory ducts that transport digestive enzymes (amylase, protease, lipase) into the duodenum. The endocrine part of the organ is the islets of Langerhans, which produce insulin, glucagon, somatostatin, ghrelin and pancreatic polypeptide.
The macroscopic structure of an organ consists of a head, body and tail. It is in the tail that hosts a large number of pancreatic islets that produce hormones.
Structural imbalances in the size of the gland, an increase in the organ as a whole or in its individual departments may indicate the presence of disorders in the tissues and the development of the disease. An increase in the size of the entire organ is total. In the case of an increase in the size of individual parts of the pancreas, it is called local.
The organs of the gastrointestinal tract and the endocrine system are closely interconnected, so the slightest malfunction in the functioning of the gland leads to problems in the functioning of both the digestive and endocrine systems.
There is a whole range of destructive processes testifying to the processes occurring in the pancreas and provoking the development of diseases.
This condition can be physiological, developing as a result of the natural processes of aging. It accompanies severe debilitating diseases (cachectic form). Atrophy is the outcome of all forms of chronic pancreatitis, while a significant part of the stroma is replaced by fibrous tissue, which is accompanied by the progression of endocrine and exocrine insufficiency.
Pancreas atrophy in diabetes mellitus occupies a special place. This pathology is accompanied by a significant reduction in the size of the gland - up to 20-18 g, the consistency is significantly densified, the surface of the organ is tuberous, the capsule is spliced with the surrounding adipose tissue, as well as neighboring organs.
At the microscopic level, the lesion is characterized by diffuse proliferation of fibrous tissue (intraacinous sclerosis), death of glandular parenchyma cells.
Pancreatic lipomatosis is also its atrophy. Despite the fact that this condition is characterized by the preservation or even increase in the size of the organ (pseudohypertrophy), most of it is replaced by adipose tissue, in which there are individual glandular areas.
In most cases, with lipomatosis, the islet apparatus and the endocrine function of the organ are preserved. Rarer cases of the disease in gastroenterology include atrophy of the gland with cirrhosis of the liver, systemic scleroderma, tumor compression, and blockage of the excretory ducts by calculi.
Symptoms of Acute Pancreatitis
Very often, pathology does not manifest itself for a long time. But there are cases when even a slight deviation from normal parameters quickly makes itself felt.
If a person has revealed at least one symptom that indicates a change in the size of the pancreas, you should immediately contact a doctor.
The doctor prescribes specific studies that will accurately determine the condition of the gland.
The main reason for the development of acute pancreatitis is a violation of the outflow of pancreatic juice and a change in its chemical composition. The provoking factors are progressive anomalies of the liver, organ trauma.
Often with a question about how to treat the pancreas, people who have problems with alcohol turn to the doctor.
Common symptoms include:
- the appearance of herpes zoster,
- nausea, vomiting,
- temperature increase up to 39 degrees,
- lowering blood pressure,
- vague dizziness.
Having received the answer to the question of how to treat the pancreas whose symptoms are rather painful, you can protect yourself from serious consequences. It is very important to strictly follow the advice of a doctor.
The most obvious symptom of pancreatic inflammation is quite severe pain in the left hypochondrium or upper abdomen. Sometimes the pain gives to the lower back and is girdle-like. When taking a sitting position or leaning slightly forward, the pain gradually subsides and becomes insignificant.
The clinical picture of the disease is determined by the cause of its development (diabetes mellitus, chronic pancreatitis and others). However, in any case, the characteristic symptoms are exocrine and endocrine insufficiency.
Exocrine (exocrine) gland insufficiency is characterized by reduced production of digestive enzymes, as well as bicarbonates and other electrolytes, which neutralize the contents of the stomach, providing an environment favorable for pancreatic enzymes.
Typical symptoms are loose stools, poor appetite, and weight loss.
As a result of a violation of pancreatic secretion and tissue death (detritus), a pathological cavity or bladder appears, which is also called a pancreatic cyst. The cause of such a neoplasm can be:
- not treated forms of chronic and / or acute pancreatitis,
- mechanical trauma to the pancreas,
- hemorrhages in the parenchyma.
By their etiology, such neoplasms can be both congenital and acquired. Damaged pancreas, symptoms and treatment depend on the stage of formation of cystic formations, the condition of the ducts and the presence of clinical complications. In the formation of pancreatic cysts, there are several periods or stages of formation:
- Stage I - from the onset of pancreatitis for 4-6 weeks, initial formations of the cyst cavity are formed,
- Stage II - capsule formation lasts for 2-3 months after the diagnosis of pancreatitis,
- Stage III - after a six-month formation of the capsule, the walls of the neoplasm (cyst) acquire a dense fibrous tissue structure,
- Stage IV - the cyst becomes isolated, that is, formed, and has certain degrees of mobility.
As a result of a violation of pancreatic secretion and tissue death (detritus), a pathological cavity or bladder appears
Pancreas, symptoms of the disease, the treatment of which consists in urgent surgery:
- The person has obstructive jaundice, indicating obstruction of the bile ducts.
- Suppuration of the body and isthmus of the pancreas.
- Rupture of a cyst and its breakthrough into the peritoneal and / or pleural cavity, as well as to neighboring organs.
- Cystic bleeding.
All this in 30% is due to a delay in the drug treatment in the early stages of pancreatic cyst formation.
It is known that the gland is responsible for the hormonal support of the digestive processes in the body. An urgent problem in medicine today remains an increased level in the blood of a significant category of citizens not only in Russia, but also in other countries. This is perhaps the problem number 2 after AIDS.
This endocrine pancreatic disease, symptoms and treatment (diet), which are associated with the restoration of hormonal levels of insulin in the blood, is called diabetes mellitus. This type of endocrine disease is associated with chronic disorders of the pancreas in the work of metabolic processes:
- protein and mineral.
According to the etiological classification, diabetes mellitus can develop according to four typical signs and have the course of the disease from mild to severe, insulin therapy in the dosage of such patients reaches 70 OD and higher.
Symptomatic signs of a different degree of the disease have different symptoms, which are set strictly individually within the walls of medical institutions, and depending on this, the appropriate medication is prescribed.
An important condition for treatment is the need to follow a strict diet. All dietary recommendations have their own characteristics depending on the degree of the disease, gender and age of the patient.
Therefore, all the full consultation on dietary nutrition, based on the physiology of the patient, can be obtained from the attending physician and / or nutritionist at the place of residence.
Diagnosis of pancreatic atrophy
When a person has a pancreas sore, treatment is prescribed only after diagnosis. Having clarified the diagnosis, the doctor will be able to accurately answer the question of how to treat the pancreas.
Diagnosis of pancreatitis is carried out by:
- Biochemical and clinical blood analysis.
- Ultrasound examination of the abdominal organs.
When pancreatitis worsens, a person should seek the advice of a gastroenterologist. Often, a cardiologist or hepatologist can answer the question of how to treat the pancreas. Nutrition is recommended to discuss with a nutritionist.
If there is a suspicion of pancreatic inflammation, the following medical specialists may participate in the diagnosis of this disease: therapist, surgeon, family doctor, gastroenterologist. A visual examination is performed, a blood test is prescribed, which can indicate the presence of obstruction of the ducts or their infection.
Then, other studies are additionally prescribed, including ultrasound, which is the most common painless diagnostic procedure.
During the examination, a deficit of body weight is determined. The skin is dry, flaky.
With a decrease in the size of the gland, it is not possible to palpate it. If the cause of the condition is pancreatitis, pain may be felt when palpating.
When conducting biochemical blood tests, a decrease in the activity of pancreatic enzymes is determined. The characteristic symptoms are steatorrhea detected during the coprogram (more than 9% of fats from daily consumption are detected in feces) and creatorrhea (high content of muscle fibers in feces).
Often diagnosed as an increase in blood glucose, which is the reason for consultation with an endocrinologist or diabetologist.
With ultrasound of the pancreas, a decrease in its size, densification of the structure, increased echogenicity, unevenness of the contours are determined. For a more detailed visualization of the organ, to determine the cause of atrophy, an MRI of the pancreas is performed.
In order to assess the condition of the ductal system, the changes of which are characteristic of chronic pancreatitis, RCP is shown - endoscopic retrograde cholangiopancreatography (contrast x-ray examination).
With its help, you can detect a narrowing of the main pancreatic duct, roughness of the walls, sinuosity. To exclude neoplasms of pancreas, angiography is performed.
An important diagnostic method is a pancreatic biopsy. When examining a biopsy, the degree of fibrosis and destruction of the parenchyma, the degree of damage to the glandular elements, islets of Langerhans (insulin-producing zones) are assessed. In the case of lipomatosis, fatty degeneration of the organ is detected. A biopsy can evaluate the prognosis of the disease.
Heterogeneous structure treatment
In order to prevent a further change in the structure of the pancreas, it is necessary to undergo the necessary studies and begin effective therapy. The main components of the treatment are special nutrition and medication.
As a rule, diet No. 5 is prescribed, which excludes foods that aggravate the digestive process. Food should be fractional: the optimal number of meals is 5-6 times. Dishes must be cooked in a baked, boiled form or steamed. Food should not be too cold or hot.
From the diet, you need to exclude fried and fatty foods, pickles and canning, chocolate and other sweets, pastries and flour products, chicken eggs and alcohol.
During an exacerbation of pancreatitis, therapeutic fasting is prescribed. The duration of such treatment is 3-4 days. During this period, you can take only warm alkaline water, for example, Borjomi.
Before using medical products of synthetic origin.
A good therapeutic effect on the state of the pancreas is provided by dietary nutrition. For this purpose, you should abandon the use of spicy, smoked and fatty dishes.
Normalize the gland in an adult can be through the use of a range of drugs.
Most often, the administration of tablets related to certain groups of drugs is prescribed.
Drug treatment of acute or alcoholic pancreatitis can be carried out at home.
For this purpose, the following groups of drugs are used:
- proton pump inhibitors
- hormonal drugs
- drugs - histamine receptor blockers,
- funds with pancreatic enzymes in their composition.
Additionally, it is possible to use antipyretic, antiemetic and analgesic drugs. Ibuprofen or Ketorol tablet quickly relieves pain. To lower the temperature, you can use Paracetamol or Citramon. These drugs should be used with extreme caution if treatment is carried out in a woman who is in the process of bearing a child.
Effective antiemetic drugs during treatment are drugs such as:
With home treatment for the disease, it must be accompanied by a dietary intake.
The basis of the diet includes various cereals and lean meat. It is forbidden to use in the diet those products that require enhanced secretion of pancreatic juice. It is forbidden to drink alcohol.
With timely treatment, it is possible to avoid the appearance of serious complications in the body.
In childhood, a pathological condition of the gland, which is due to a hereditary predisposition, can be fixed. When treating an enlarged pancreas in a teenager, both conservative and surgical treatment can be used. The choice of treatment method is carried out by the attending physician, taking into account the characteristics of the body.
Information on pancreatic diseases is provided in the video in this article.
How to cure the pancreas? It is possible to treat an acute form of the disease only in a hospital. In the presence of complications, the person is placed in intensive care. The answer to the question of how to treat the pancreas with a chronic form is possible, according to the activity of symptoms. The main goal of treatment is to get rid of the pain syndrome and restore the organ's working capacity.
Pain is stopped by medicines. Take the drug according to the doctor's recommendations. Often, a specialist prescribes the use of:
When the chronic form of the disease worsens, when answering the question of how to cure the pancreas, the doctor prescribes the passage of antimicrobial therapy. The patient is prescribed the use of Claforan, Kefzol, Ampicillin.
Most patients want to know how to treat the pancreas at home. There are many recipes that help relieve symptoms and improve the quality of life of the patient. Therapy with folk remedies is carried out under the strict supervision of a doctor.
How to treat the pancreas with moderate pain? Decoctions from:
To make a decoction of calendula, you need to brew 200 mil. boiling water one spoon of herb. It is necessary to insist the remedy for four to eight hours. Take the drug three times a day, 35 minutes before eating. The duration of the therapeutic course is 1.5-2 months.
How to treat a person if the pancreas is ill? Grated pumpkin comes to the rescue. First you need to boil 150 grams of millet in two liters of water, then mix with two hundred grams of the main ingredient. Add salt, olive oil and mix. It is necessary to take medicine within 21 days.
Most often, treatment is performed in a hospital setting. An ill person is prescribed pain medication, and a special medication regimen is being developed to eliminate inflammation.
With pancreatitis, air and fluid sometimes accumulate in the stomach, which can cause severe vomiting. To eliminate this symptom, a tube is inserted into the stomach through the nose, which brings fluid and air out.
The choice of therapy for pancreatitis will depend on the nature of the disease: an acute attack or a chronic course. Initial treatment for an acute attack of pancreatitis should be carried out in a hospital setting.
The patient is prescribed intravenous infusion to make up for fluid loss and normalize blood pressure. To eliminate inflammation, NSAIDs are prescribed.
During this period, from three days to a week, a strict diet is followed.
In the presence of gallstones, which provoke attacks of inflammation of the pancreas, ERCP (endoscopic retrograde cholangiopancreatography) is prescribed to remove them from the bile duct. After the elimination of inflammatory processes, the gallbladder is sometimes removed surgically.
In the chronic course of the disease, when acute attacks of pancreatitis appear, a similar treatment is prescribed. If it is necessary to expand the ducts of the pancreas, remove stones or cysts, it is necessary to resort to surgical intervention.
After such a procedure, a person should be constantly observed by the attending physician for about six months to avoid complications. At home, you should constantly adhere to an appropriate diet, avoid overeating and alcoholic beverages.
Medicines for the treatment of chronic pancreatic inflammation
In the treatment of the chronic form of pancreatitis, pain medications, enzymes that improve the digestion of food are prescribed, and if necessary, insulin-containing drugs.
The main types of drugs for the treatment of pancreatitis:
Painkillers. If the pain attacks are tolerable, then they can be stopped with ibuprofen or acetaminophen. In case of more intense and sharp pains, as prescribed by a doctor, stronger painkillers are used,
Insulin. If inflammation led to the death of pancreatic cells responsible for the production of insulin, then the patient is given life-threatening injections of insulin,
Enzymes With a severe form of inflammatory processes in the pancreas, this organ can stop the production of digestive enzymes, which are vital for the digestion and proper absorption of fats, carbohydrates and proteins. In this case, the patient is prescribed an intake of enzymes. Entering the body, they help food to be fully absorbed.
First Aid Comments
If a person is concerned about pancreatic treatment should be immediate. Within 24 hours, a person should exclude food intake. This will help reduce the burden that is placed on the organ.
A cold compress should be applied to the sore spot. Applying ice helps to slow down the development of swelling in the tissues of the organ.
The patient needs to drink as much as possible. Water must be very high quality.
A person should drink at least two liters in 24 hours. People who have first-hand knowledge of the disease know how to calm the pancreas.
Instead of water, they drink an alkaline mineral water. The outflow of pancreatic juice and bile is improving.
Perhaps the use of antispasmodics. In order to stop the spasm of the sphincter of the main duct, these medications are administered intramuscularly to a person. Then you need to call an ambulance. Arriving specialists will treat the pancreas, based on the severity of symptoms.
Prevention of pancreatic inflammation
It is impossible to prevent inflammation of the pancreas, like any other disease.
Diet is the main therapeutic and preventive measure for exacerbation of the pancreas. However, at home, other preventive actions can be carried out using various food products:
- Dill treatment. Plant seeds (10 g) are poured with boiling water (200 ml) and insisted for one hour. After that, you need to drink such green water on an empty stomach.
- Treatment with garlic, lemon and parsley. Take 300 g of garlic and parsley, and mix with a kilogram of lemons, grind in a meat grinder. Then, every day before meals, eat 20 g.
- Treatment with kefir and buckwheat. Cook buckwheat porridge (without salt), cool, and then pour in low-fat kefir. Eat at any time of the day, if desired.
- Golden mustache treatment. Grind a couple of stems of this plant and pour 500 ml of water. Cook for 30-40 minutes, insist and take a decoction 2 times a day in the morning and in the evening before bedtime.
Pancreas: symptoms and treatment (diet) for diabetes
Improving the condition contributes to the treatment of the pancreas with hunger. On the first day, the patient is advised to completely refuse food. Drink only high-quality mineral water. Mineral water “Narzan” and “Borjomi” helps best.
When the disease worsens, the patient should drink at least one and a half liters of mineral water. The dosage decreases as the pain syndrome retreats.
How to treat the disease, if the pancreas continues to bother, should tell a specialist. Against the background of therapy, a person should adhere to a strict diet. On the second day, the menu should be varied with inedible buns, crackers and bagels. It is better to drink black tea. Then allowed to eat low-calorie foods.
What is the pancreas treated with during a diet? The patient is prescribed medications that help improve digestion.