Аcute and chronic pancreatitis

Etiology
• rare in children
• parotitis
• complication of acute respiratory infection,
dysentery, cholecystitis and other somatic diseases
Рathogenesis

edema develops

outflow of pancreatic juice

absorption of enzymes into the blood

In severe cases, hemorrhages, foci of

necrosis, tissue autolysis, general
intoxication occur
Clinical features

• the beginning is acute

• epigastric pain

• pain of a girdle nature, radiating to the lumbar region, the

left half of the chest, to the back

• due to severe pain, the development of a coloptoid and

shock state is possible.
• The color of the skin and mucous membranes is pale with a cyatonic shade

• Cullen's symptom - yellowish-cyanotic coloration in the navel

• Mondor's symptom - purple spots on the skin of the face and trunk

• Halsted's symptom - cyanosis of certain areas of the anterior surface of the

abdomen

• Gray Turner's symptom - pigmentation of a bluish or greenish color on the

lateral areas of the abdomen,

• Symptom of Grunwald-ecchymosis or petechiae around the navel, gluteal

areas

• Kerte's symptom - with superficial palpation muscle tension of the abdomen

of the left rectus muscle, respectively
Mayo-Robson's point – a point on border of inner 2/3 with the external 1/3 of the line that represents the
bisection of the left upper abdominal quadrant, where tenderness on pressure exists in disease of the
pancreas. At this point the tail of pancreas is projected on the abdominal wall.

Desjardins point. Desjardins point: a point on the abdomen 5 to 7 cm from the umbilicus, on a line joining
it to the right axilla; it lies over the head of the pancreas.
• the tongue is coated, the abdomen is swollen, nausea, vomiting that does not
bring relief, the stool is frequent or delayed

• fever

• leukocytosis with neutrophillosis, increased ESR

• high diastasis in urine and blood

treatment

• hospitalization

• intravenous isotonic solutions of glucose and sodium chloride under the control of
electrolyte balance

• albumin, plasma, hemodez, reopolyuglyukin, cardiac drugs

• To relieve pain but shpa, papaverine

• In order to reduce pancreatic secretion, atropine, platifillin, ganglion blockers

• Antienzymes

• To suppress a secondary infection: antibiotics

chronic pancreatitis is a consequence of acute
pancreatitis, the result of inflammation of the
pancreatic ducts or the involvement of the pancreas
in the inflammatory process of gastroduodenitis,
intestinal giardiasis.
diagnostics
in an increase in blood amylase activity, lipasemia, blood leukocytosis,
neutrophilic shift to the left, eosinophilia, thrombocytopenia

coprogram:
fatty acid
extracellular starch
altered muscle fibers

echography
swelling of the pancreas against the background of focal changes of a fibrous
nature
Periods of pancreatitis

• The period of exacerbation

with the exogenous function
of the pancreas

• period of incomplete
remission

• complete remission period