Health, Diseases and Conditions
Acute necrosis of the pancreas. Symptoms, treatment
The pancreas is located behind the peritoneum at the level of the I-II vertebral segments of the lumbar region. This body participates in the most important processes in the body. Further we will understand, what functions at it, what can be infringements in its activity. In particular, consider how acute pancreatic necrosis is manifested.
General information
The pancreas (size norm: 15-10 cm - length, 2-3 cm - width) is considered a fairly large organ. Its weight in an adult is about 100 g. At birth, its mass is not more than three grams. In the human body, the body performs two important functions. Let us consider them in detail later.
Functions of the body
External secretion of the pancreas is important for the duodenum - pancreatic juice is secreted into it . It contains enzymes: amylase, lactase, maltase, lipase, trypsin and others. Due to pancreatic juice, neutralization of acidic gastric contents and digestion of food occurs. Initially, enzymes are produced in an inactive form, later activated in the duodenum. Their action is aimed at splitting carbohydrates, fats, proteins into the main components.
Protocols
Inside the gland is a canal opening into the duodenum. Common biliary and pancreatic ducts in most cases form an ampoule. As a result, they open in the large nipple of the duodenum. In the ducts of the pancreas, normal pressure should be higher than in the common bile duct. This is due to the need to prevent the release of the contents of the intestine and the gallbladder.
Violations of the body
With changes in the pressure difference in the pancreatic ducts, hypertension appears. It is associated with a difficult outflow of pancreatic juice, ejection of the contents of the gallbladder or intestine. Against the background of increased pressure, the cells of the pancreas begin to be damaged. From them, enzyme compounds are released and activated. They penetrate the parenchyma, adipose and connective tissue of the gland. As a result, a chain reaction occurs. With the help of one enzyme, another is released. This provokes an inflammatory process, leading to increased blood circulation, and subsequently - to stagnation of blood. This promotes thrombogenesis in the gland. As a result of a circulatory disorder, pancreatitis occurs, often provoking necrosis of the pancreas.
Causes of activity violations
The pathological condition, as a rule, appears as a result of a single or repeated pancreatitis attacks. The acute form is directly related to cholelithiasis. As provoking factors, an ulcer (stomach or duodenum), cirrhosis, hepatitis, alcoholism.
Important information
As mentioned above, one of the functions of the gland is the intrasecretory production of hormones. In the fulfillment of this task, the islets of Langerhans take part . In case of their defeat against a backdrop of pathologies, including pancreatitis in chronic course, fatty degeneration in the liver and diabetes (sugar) develop. The pancreas is able to adapt itself to the type of nutrition. It all depends on the food you eat. When receiving a large volume of carbohydrates, more enzymes that split them are activated. If fatty foods predominate, then more lipase is produced, and if protein - trypsin. However, these features should not be abused. The fact is that the pancreas very rarely signals about probable overload. As a rule, a rather violent reaction is manifested, which indicates not about the initial stage of pathology, but about its full flowering.
Consequences of neglected diseases
A disregard for the condition of the pancreas can provoke various complications. The danger consists mainly in the fact that next to it are other organs that are of no less importance to the organism. This, in particular, the spleen, liver, stomach. The heart does not stand aside either. In case of violations in the pancreas, this organ is also subjected to a load. Changes in the operation of systems occur very quickly. For the pancreas, sometimes a few hours are enough.
Acute pancreatic necrosis
This process is the death of organ tissues. Its development is influenced by various traumatic factors. At the heart of them is the inflammation of the body. Acute necrosis of the pancreas develops in the event of prolongation of her examination and treatment. In the process, the active enzymes of the organ are actively involved. Under their action, the pancreas is digested. With the activation of interstitial enzymes, pathological processes progress. As a result, foci of fat necrosis are formed.
Process description
As a result of the cleavage of fatty acids, a pH shift occurs. This activates the intracellular trypsogen. Subsequently, it is transformed into trypsin. This compound, in turn, activates proteinases that form certain proteolytic foci. Enzymes begin to erode the vascular walls and connective tissue. The destructive process goes beyond the pancreas. In this case, restoration of the organ becomes impossible. If there are obvious signs, the lethal outcome can be instantaneous.
The provoking factors
Necrosis of the pancreas, the symptoms of which will be discussed below, is most often the result of excessive consumption of alcohol, overeating, dyskinesia in the biliary tract, disorders of the outflow of enzymes on the background of cholangitis, calculous cholecystitis. To cause a pathology may be improper intake of medication, dose disruption and scheme of use. Acute necrosis of the pancreas can be caused by frequent infectious diseases, stresses.
Course of pathology
Depending on the area of distribution, acute necrosis of the pancreas can be extensive and focal. The process can quickly progress or flow rather sluggishly. In accordance with the type of pathological course, pancreatic necrosis is divided into destructive, functional, haemostatic, hemorrhagic and edematous. The latter is considered the most mild form. Due to puffiness, the pancreas is enlarged, which causes an increase in pressure on the pancreas and microcirculation disorder. Treatment of edema is usually successful. When untimely referral to a specialist pathology takes a more neglected appearance. In particular, the necrotic process disrupts the outflow from the pancreas of digestive enzymes. As a result, digestion of the organ from within begins. With the passage of the process, penetration of pus into the abdominal cavity begins. As a result, acute peritonitis develops. In this case, surgical intervention is inevitable. Otherwise, sepsis will start, which will lead to death.
Clinical picture
How is pancreatic necrosis manifested? Symptoms of pathology are quite intense. In the left hypochondrium develops soreness of the surrounding nature. It extends all over the body below the ribs. Pain gives in the shoulder and shoulder blade, as in a heart attack. The processes are accompanied by abundant vomiting, bloating, flatulence. The patient's temperature rises, the skin turns pale or turns red. The main symptom of the pathological condition is considered to be the Gray-Turner symptom. It manifests itself in the form of bluish spots from the sides of the abdominal cavity. With palpation of the wall, soreness and tension are noted. Diagnosis is carried out on the basis of visual inspection, patient complaints, as well as on the results of instrumental and laboratory studies. Ultrasound is used to assess the echogenicity of the parenchyma. CT and MRI, angiography and laparoscopy can establish the exact onset of the disease.
Therapeutic events
Treatment of acute necrosis can be both surgical and conservative. The choice will depend on the pathological changes in the organ. The medication effect is administered on an individual basis. Among the drugs recommended for admission - antispasmodics ("No-shpa", for example), antiferment and cytotoxic drugs that affect enzyme synthesis. From surgical methods, laparotomy and laparoscopy are used. However, during the operation, it is not always possible to eliminate the pathology completely. In general, patients are treated in hospital settings.
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