- Pancreatonecrosis reasons
- Pancreatonecrosis symptoms
- Treatment of a pancreatonecrosis
Pancreatonecrosis - dying off of a considerable part of cells of a pancreas.
As the pancreatonecrosis is the final of development of some types of an inflammation of a pancreas, to its reasons there will be all those that lead to pancreatitis.
effect of poisons. Including, and ethanol.
autoimmune inflammation of gland. Action of cells of immunity against own fabrics.
destruction of fabric as a result of direct action of the injuring factor.
destruction of gland in a consequence of tumoral process.
But independent development of a pancreatonecrosis is possible only at a direct injury of gland. In all other cases, it develops after the postponed acute pancreatitis and always against the background of chronic inflammatory process in gland fabrics.
In most cases the pancreatonecrosis develops quickly. The patient begins to be disturbed suddenly at first feeling of weight in a stomach and nausea which then passes into repeated vomiting. There is a severe acute pain in left hypochondrium. Often pain has surrounding character – when all upper half of a trunk slightly below than edges hurts. At back localization of a pancreatonecrosis symptoms can remind themselves symptoms of heart attack. The characteristic syndrome – pain can irradiate in the left shoulder and under a shovel.
The patient manages to achieve weakening of a pain syndrome only in a sitting position with densely tightened to a stomach by the legs bent in knees. All this can be followed:
fervescence to subfebrile figures;
repeated plentiful vomiting after which the sick person does not feel any sense of relief;
reddening of integuments or their pallor in a stage of development of a vascular collapse;
increase in level of pancreatic amylase when carrying out biochemical analyses of blood and urine;
emergence of skin sites of the increased painful sensitivity (hyperesthesia).
Against the background of development of a necrosis of a pancreas phlegmon of an abdominal cavity, ascites can develop. In hard cases the exudate of liquid is observed in pericardiac covers that significantly complicates activity of cardiovascular system. With development of symptoms of a pancreatonecrosis the hemorrhagic exudate in a pleural cavity is formed.
At defeat of fabrics of insular cells sugar level in blood sharply increases that can lead to development of a hyper glycemic coma. A symptom, characteristic of a pancreatonecrosis, – emergence of spots of dark blue color on side surfaces of a front wall of a stomach. This symptom carries Gray-Turner's name. At Gryunvold's syndrome cyanotic and crimson spots can be found around an umbilical hollow and if bruises are formed on a rump and under edges behind, then Davies's syndrome is established.
The diagnosis is established in the presence of a repeated cholemesis against the background of the strongest pain syndrome of the surrounding character. It can be followed by abdominal distention and a meteorism. At the same time a palpation of a front wall of a stomach in the field of an epigastrium and the right hypochondrium do not give such pain syndrome of which the patient complains. Pains most often have acute, intolerable character. Patients have burning sensation from a back and areas of a stomach are slightly more right.
Treatment of a pancreatonecrosis:
Treatment includes both conservative and operational methods of treatment.
For an intensive care, the following groups of drugs are applied.
spasmolysants: Platyphyllinum, atropine, papaverine. Drugs promote relaxation of fabrics of gland and its channels. As a result outflow of a secret of gland improves.
blockers of work of enzymes: Contrykal, Gordoxum, ftoruratsila. They, contacting active centers of enzymes, lead to reduction of their chemical activity, practically up to zero.
antisekretolitik: омез, ranitidine, famotidine, etc. These drugs reduce secretion of a gastric juice that reflex reduces activity of work of a pancreas.