Various methods of examination in determining the diagnosis allow the most accurate conclusion about the causes of impaired body functions. One of the most common methods for suspicion of impaired functioning of various organs of the digestive system is palpation of the abdomen.
Symptom Resurrection: clinical manifestations
When carrying out palpation of the abdomen in the epigastrum, it is determined that the patient has no or significantly weakened pulsation of the ventral part of the descending aorta. Such a symptom is a characteristic sign of acute pancreatitis.
But the symptom of Voskresensky is not pathognomonic. That is, similar phenomena can be evidence not only of acute pancreatitis, but also of retroperitoneal hematoma, an increase in some lymph nodes, etc.
Justification from the topographic-anatomical point of view
It is known that the pancreas is projected on the anterolateral abdominal wall in the epigastric region and on the left subcostal area. The lowest part of the pancreas and the lower edge are projected at a distance of about 5 cm above the navel location, and the top - about 10 cm above the navel. The location of the head of the pancreas is to the right of the VI-VII rib, and the tail is the left hypochondrium.
Retroperitoneal arrangement of the head causes its close connection with the duodenum. Behind the pancreas is the abdominal part of the descending aorta.
If there is no pathology, in the process of palpation of the abdomen in the epigastrum, pulsation of the aorta is easily determined.
The absence of pulsation in the abdominal area of the descending aorta in the presence of acute pancreatitis can be explained by the fact that the enlargement and consolidation of the pancreas results in the fact that it blocks a significant portion of the aorta from the front, which prevents the palpation of its pulsation.
Other symptoms with pancreatitis
The symptom of Voskresensky with pancreatitis is one of the most important manifestations of this disease.
Pancreatitis is an inflammatory-dystrophic disease of the pancreatic tissue. It often appears as a chronic form and has a rapidly progressive nature. The final stage is characterized by the cessation of the performance of the pancreas by its functional.
The most common causes of this ailment are:
- Frequent and excessive consumption of alcoholic beverages.
- Diseases of the bile excretory system (usually in women).
- Diet with insufficient protein and fat.
- Hereditary pathologies associated with impaired amino acid metabolism.
The predominant part of complaints is associated with the emergence of severe pains of different localization. Acute pancreatitis causes unbearable pain in the upper abdomen, giving in the back. Chronic pain syndrome is characterized by a lesser intensity and sometimes, in pain, resembles a heart attack.
Objective symptoms of pancreatitis, including the symptom of Voskresensky, are not associated with the pain threshold of the patient, therefore these signs become in this case the main criterion in determining the diagnosis. They also include the apparent yellowing of the sclera of the eyes; The complexion of the patient varies from pale to earthy; The ocular cavity becomes pronounced; The appearance of spotting on the abdomen and in the groin; The tongue becomes yellow; Breathing becomes faster; There are severe pain during palpation.
Methods of examination for suspected acute appendicitis
In female representatives, acute appendicitis is much more common than in men. It appears, as a rule, suddenly. There are severe pains in the epigastric region, intensifying and spreading throughout the abdomen. Then there is localization of pain in the right ileal region (Kocher's symptom). Often there may be a single vomiting, stool retention. In some cases, diarrhea is also possible, which is exacerbated if the inflamed vermiform appendix is localized in the pelvic region. Irradiation of pain in the lumbar region or the right leg is possible, which is called "the symptom of tying the shoe."
If there are destructive forms, then the easing of pain and the appearance of chills are characteristic; Increased heart rate and a slight increase in temperature. In this case, thirst arises, and the stomach remains of the correct form. Inspection allows you to diagnose the lag in the breath in the zone of the right lower abdomen. There is hyperesthesia of the skin in the right iliac region, which is called the symptom of Razdolsky. There are also clinical manifestations of the Crimean symptom, consisting in soreness in the process of palpation of the right inguinal ring
Retrocecal location of the appendix in case of acute appendicitis provokes activation of muscular protection in the lumbar triangle (Pettitov's symptom).
Symptom of slipping (Voskresensky) with acute appendicitis
The symptom is that the doctor, being on the right side of the patient, pulls his shirt down with his left hand, and the right one gently slips the fingertips in the direction from the epigastric region to the right iliac. It is important, at the end of the slip, not to immediately remove the fingers from the abdominal wall. The fact is that at the end of slipping the patient feels a sharp pain. At the same time, when sliding in the opposite direction, pain sensations do not arise.
In which cases is this symptom positive?
So, the symptom of Voskresensky is positive, when the patient has acute pancreatitis. A symptom of slip, also discovered by this scientist, is observed in the case of acute appendicitis.