Virsungov duct of the pancreas. Expansion of the Virundian duct

The role of the pancreas is unusually great. This body of external (exocrine) and internal (endocrine) secretion is involved in the digestive process and regulation in the body of lipid, carbohydrate and protein metabolism. Problems in the work of the body are reflected in the state of the Virundian duct. Acute inflammation of the gland is expressed by its expansion, and in chronic pancreatitis its extensions are observed, alternating with sites of stenosis (constrictions). With diseases of the gland in the excretory duct, changes occur, identified by modern diagnostic methods.

Virsungi duct

The main pancreatic duct extends along the entire length of the pancreas, reaching its posterior surface. Virsungov duct, formed from the fusion of smaller ducts of the lobule of the organ, on average has a length of 20 cm. This channel often terminates in the duodenum, at the site of the formation of such an organ as the sphincter. The constructive connection of the excretory duct of the gland with the duodenum is functional enough, its result is the treatment of pancreatic juice produced by the intestinal contents.

The size and shape of the Virsungova duct in many people do not coincide and depend on the individual structure of the organism. In the majority, it combines with the common bile duct (choledochus) and enters the duodenum. The ratios of its terminal parts, together with the common duct, can be different. There are four types:

• The joint confluence of both ducts into the gut, where they form a kind of ampoule. Oddi's sphincter, while embracing both ducts, cuts them completely when cut. A similar type is observed in 55% of cases.
• The connection of both ducts near the duodenum without the formation of a common ampoule. This type is typical in 33.6%.
• Separate confluence in the duodenum of each of the ducts. This is a fairly rare type of ratio, found in 4%.
• Merging the ducts at a considerable distance from the fecal nipple. Both of them open into the duodenum and adjoin their walls. Approximately 8.5% of cases show that this merger is separate.

These anatomical features are important enough when the pathological changes in the Virpsong duct are likely. The interconnection of the common bile duct with the main duct and the gland head, their connection with the duodenum play a significant role in understanding and developing a number of symptoms of pathologies and pancreatic cancer.

Ultrasonic picture

Modifications of the pancreas (violation of the organ parenchyma) can be caused by various causative factors. They are visible in ultrasound examination, which allows you to assess the size and structure of the parenchyma, see the contours, the presence of pathologies, as well as the state of the ducts of the gland. Signs of certain diseases, Diagnosed At survey, show also probable deviations which can cover pills of the pancreas.

By the way, it should be noted that many healthy people may have symptoms of diffuse changes associated with the environmental situation and the use of products with various preservatives and stabilizers.

Signs of pathology with ultrasound

More often, such diseases as acute and chronic pancreatitis , pancreatitis, cysts and other pathologies are detected.

Diffuse enlargement of the parenchyma of the gland often causes acute pancreatitis. During examination, the contours of the organ are blurred, blind spots can be observed in its structure, which may be a consequence of hemorrhage or necrosis of the gland. The expansion of the Virsung duct and other ducts of the gland is determined.

With chronic form of pancreatitis, the size of the organ can not be changed. Its contours do not become indistinct and uneven. The echoes of the gland tissue are reduced. In the presence of fibrosis, the parenchyma is compacted, the virsunga duct is deformed and narrowed, and its walls are compacted. Often, there is a violation of patency of the gland ducts. Such inflammatory changes are a consequence of the formation of cysts and calcifications.

The formation of stones in the parenchyma, or pancreatitis, is the result of inflammatory processes of the gland or disturbance of the outflow of enzymes. Initially stagnation is observed in the ducts of the organ, which is expressed by the expansion of the Virpsong duct. At the next stage of the development of the pathological state, the protein precipitates in the pancreatic juice and deposits calcinates, which is expressed in the ultrasound study as a diffuse increase in the echogenicity of the parenchyma. The neglected form of the disease leads to pancreatitis.

The structure of the gland can be affected by pathological conditions of other internal organs (chronic heart failure, hepatitis, cirrhosis).

Deviations detected in the pancreas may be due to its various diseases, but more often causative factors are pancreatitis and pancreatitis.

Pancreatitis

From a clinical point of view, pancreatitis (an inflammatory process of the pancreas) can occur in acute or chronic form. The cause of the disease can be the cessation of the juice produced by the organ in the duodenum due to the obstruction of the duct. With prolonged inflammation, the enzymes of the gland begin to digest their own cells. The cause of inflammation can also be damage to the gland due to its swelling.

Acute pancreatitis is more often due to the presence of gallstones that block the ducts, or alcoholism, the consequence of which is the obstruction of the small ducts of the organ.

Pancreatitis

Pancreolithiasis is a pathological condition characterized by the formation of stones in the thoracic duct of the gland or its branches. Signs of the disease are spasmodic pains in the epigastric zone, radiating into the lumbar region.

The presence of stones, preventing the outflow of pancreatic juice, leads to digestive disorders. With a similar stagnation in ultrasound, it is revealed that the virsung duct is enlarged, and Stretching the walls of small ducts.

However, it is worth remembering that the ultrasound picture does not provide full information for the diagnosis. Additional surveys are needed. Since often in the detection of diffuse modifications of the pancreas or liver, for example, the ducts are not visualized. To study it in more detail help other methods of diagnosis.

Difficulty in diagnosing

The complexity of the diagnosis of the pathologies in question is related to the location of the pancreas. It is deep enough in the human body. Her research should be conducted only by qualified specialists and include advanced instrumental and laboratory techniques. This is a careful study of the level of pancreatic enzymes (pancreatic isoamylase, lipase, trypsin in the urine, in the blood, in duodenal contents). To determine the exocrine deficiency of the gland, it is necessary to determine the parameters of fecal elastase in feces. Important general blood test, assessment of glycemia, sonography of the abdominal cavity, Doppler.

To obtain axial sections of the abdominal cavity organs, an MRI is prescribed.

In difficult situations, diagnostic laparoscopy is also performed . Since the pancreas is often affected by the pathology of pancreatic ducts and bile ducts, ERCP is necessarily performed.

MR-cholangiography

Magnetic resonance cholangiopancreatography with obstructive form of pancreatitis allows detailed study of the state of the Virundian duct. This is one of the most modern methods of non-ionizing examination of the gallbladder, its ducts and pancreatic Duct. It provides an opportunity to obtain the most accurate information about the status of these organs, to determine the presence of polyps, concrements, strictures in them, to visualize changes in the vessels and lymph nodes.

Treatment

The treatment of diffuse changes revealed in the pancreas can be carried out by conservative and operative methods. The choice of the correct treatment tactics largely depends on the nature of the pathology, the presence of concomitant diseases and the general condition of the patient.

Often because of untimely diagnosis and treatment, echogenic signs are irreversible, not subject to reverse development.

Restoration of the normal structure of the body is possible only with timely adequate therapy and compliance with all the recommendations of a specialist.