Chronic pancreatitis (acute pancreatitis) — a chronic inflammation of the pancreas. Usually found in middle and old age, more often in women. There are primary and secondary chronic pancreatitis or concomitant developing in other diseases of the digestive tract (chronic gastritis, cholecystitis, enteritis). In chronic can go a prolonged acute pancreatitis, but more often it is formed gradually with chronic cholecystitis, cholelithiasis, or under the influence of haphazard irregular supply, frequent eating spicy and fatty foods, chronic alcoholism, especially when combined with a systematic deficiency in food proteins and vitamins, penetration stomach ulcer or duodenal ulcer in the pancreas, atherosclerotic vascular lesions of the pancreas, infectious diseases, some gepmintozov, chronic intoxications lead, mercury, phosphorus, arsenic.
The pathogenesis of chronic pancreatitis.
Delayed allocation and intraorganic activation of pancreatic enzymes — trypsin and lipase performing autolysis parenchyma of the gland, reactive growth of scar shrinkage and connective tissue, which then leads to organ sclerosis, chronic circulatory problems in the pancreas. In professirovanii inflammation are important processes of self-aggression. In chronic pancreatitis infectious origin pathogen can penetrate into the pancreas from the lumen of the duodenum (for example, dysbiosis) or biliary tract through the pancreatic duct by a rising, fueled by dyskinesia of the digestive tract, accompanied duodeno- and common bile duct-pancreatic reflux. Predispose to the occurrence of chronic pancreatitis spasms, inflammation or tumor stenosis faterova nipple, preventing release of pancreatic juice into the duodenum, and the lack of sphincter of Oddi, facilitating free hit duodenal contents into the pancreatic duct, especially contained in the intestinal juice enterokinase, trypsin activation. The inflammatory process can be diffuse or limited only to the area of the head or tail of the pancreas. Distinguish chronic hydropic (interstitsiylny), parenchymal, and sclerosing pancreatitis kapkulezny.
Epigastric pain and left hypochondrium, dyspeptic symptoms, diarrhea, weight loss, joining diabetes. The pain is localized in the epigastric region right at preferential localization process in the pancreatic head, with the involvement in the inflammatory process of the body — in the epigastric area to the left, with the defeat of its tail in the left upper quadrant; often the pain radiates to the back and has a surrounding nature may radiate to the region of the heart, mimicking angina. The pain may be constant or paroxysmal and displayed a little while after a fatty or spicy foods. Marked tenderness in the epigastrium and left hypochondrium. Often there is pain in the left point costovertebral angle (symptom Mayo — Robson). Sometimes defined area of skin hypersensitivity, respectively, the area of innervation of the eighth thoracic segment left (Kacha symptom) and some atrophy of subcutaneous fat in the projection area of the pancreas on the front wall of the abdomen.
Dyspeptic symptoms in chronic pancreatitis is almost constant. Part of a complete loss of appetite and aversion kzhirnoy food. However, with the development of diabetes, on the contrary, patients may feel a strong hunger and thirst. Often there are excessive salivation, belching, nausea, vomiting, flatulence, rumbling in the stomach. Chair in mild cases, normal, in more severe — diarrhea or alternating constipation and diarrhea. Characterized by pancreatic diarrhea with copious mushy fetid with greasy luster burl; scatological study reveals steatorrhea, Creators, kitarinoreyu.
In the blood — moderate hypochromic anemia, during an exacerbation — increased erythrocyte sedimentation rate, leukocytosis, hypoproteinemia and Dysproteinemia due to higher content of globulins. With the development of diabetes, hyperglycemia and glucosuria revealed, in more severe cases, violations of electrolyte metabolism, in particular hyponatremia. Contents trypsin antitrypsin, amylase, lipase and amylase in the blood and in the urine rises during acute pancreatitis, as well as obstacles to the outflow of pancreatic juice (inflammatory edema and head compression gland ducts, cicatricial stenosis faterova nipple et al.). In duodenal contents enzyme concentration and total amount of juice in the initial stage of the disease can be increased, but expressed atrophic and sclerotic process in iron, these figures are reduced, there is a pancreatic hyposecretion.
Duodenorentgenografiya reveals the deformation of the internal circuit loop of the duodenum and depressions, caused by an increase in the pancreatic head. Sonography and radioisotope scanning shows the size and intensity of the shadow of the pancreas; in diagnostically difficult cases, a CT scan is performed.
Protracted course of the disease. The peculiarities of the current release chronic recurrent pancreatitis, pain, psevdoopuholevuyu, latent form (rare). Complications: abscess, cyst or calcification of the pancreas, severe diabetes, thrombosis of the splenic vein, scar-inflammatory stenosis of the pancreatic duct and duodenal papilla, and others. When the sclera-ziruyuschey form of chronic pancreatitis can occur obstructive (mechanical) jaundice due to compression of the segment passing it common bile duct cancer induration. Against the background of long flowing pancreatitis possible secondary development of pancreatic cancer.
Chronic pancreatitis is differentiated primarily on tumors of the pancreas, thus become important pankreatoangio radiography, retrograde cholangiopancreatography (virzungografiya), echography and radioisotope scanning of the pancreas. You may need to differential diagnosis of chronic pancreatitis with cholelithiasis, gastric ulcer and duodenal ulcer (note also the possibility of combining these diseases), chronic enteritis and less often other forms of pathology of the digestive system.
How to treat chronic pancreatitis disease?
Cold Laser Vityas help!
Methods of treatment of chronic pancreatitis medical cold laser Vityas (on photo):