Various survey methods for determiningdiagnosis allow you to make the most accurate conclusion about the causes of the violation of 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 performing abdominal palpation in the epigastriumit 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, enlargement of some lymph nodes, etc.
Rationale from the topographic-anatomical point of view
It is known that the pancreas is projectedon anterolateral abdominal wall in epigastric region and on 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 upper one - 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.
The retroperitoneal location of the head causes its close connection with the duodenum. Behind the pancreas is the ventral 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.
Absence of pulsation in the abdominal area of the descendingaorta in the presence of acute pancreatitis can be explained by the fact that the increase and consolidation of the pancreas leads to the fact that it blocks a significant portion of the aorta from the front, which prevents probing its pulsation.
Other symptoms with pancreatitis
The symptom of Voskresensky with pancreatitis is one of the most important manifestations of this particular disease.
Pancreatitis is an inflammatory and dystrophicpancreatic tissue disease. It often appears as a chronic form and has a rapidly progressive nature. The final stage is characterized by the termination of the performance of its functional by the pancreas.
The most common causes of this disease are:
- Frequent and excessive consumption of alcoholic beverages.
- Diseases of the biliary system (usually in women).
- Diet with insufficient protein and fat.
- Hereditary pathologies associated with impaired amino acid metabolism.
Преобладающая часть жалоб связана с the occurrence of severe pain of different localization. Acute pancreatitis causes unbearable pain in the upper abdomen, extending into the back. Chronic pain syndrome is characterized by a lower intensity and sometimes reminds a heart attack due to pain.
Objective symptoms of pancreatitis, includingis a symptom of the Resurrection, are not associated with the patient's pain threshold, therefore, these signs become in this case the main criterion in determining the diagnosis. They also include a clear yellowing of the sclera of the eyes; the patient's complexion changes from pale to earthy; eye sockets become pronounced; the appearance of bloody spots on the abdomen and groin; tongue covered with yellow bloom; breathing quickens; severe pains on palpation.
Survey methods for suspected acute appendicitis
Female representatives are sharpappendicitis is much more common than in men. It appears, as a rule, suddenly. There are severe pains in the epigastric region, aggravated and spread throughout the abdomen. Then there is the localization of pain in the right iliac region (a symptom of Kocher). Often there can be a single vomiting, a delay of a chair. In some cases, diarrhea is also possible, which is enhanced if the inflamed appendix is localized in the pelvic region. Possible irradiation of pain in the lumbar region or the right leg, which is called the "symptom tying shoe".
If destructive forms take place, thencharacterized by weakening of pain and chills; increased heart rate and slight fever. This causes thirst, and the stomach remains the correct form. Inspection allows you to diagnose lag in breathing in the area of the right lower abdomen. There is hyperesthesia of the skin in the right iliac region, which is called the Razdolsky symptom. There are also clinical manifestations of the Crimean symptom, which consist in pain in the process of palpation of the right inguinal ring.
The retrocecal location of the appendix in the case of acute appendicitis provokes the activation of muscle protection in the lumbar triangle (Petitov symptom).
Symptom slip (Resurrection) with acute appendicitis
The symptom is that the doctor, being withon the right side of the patient, pulls down his shirt with his left hand, and the right side gently slides his fingertips from the epigastric region to the right iliac region. It is important that at the end of the slide you should not immediately remove your fingers from the abdominal wall. The fact is that at the end of the slide the patient feels a sharp pain. In this case, when sliding in the opposite direction, pain does not occur.
In what cases is this symptom positive?
So, the symptom of Resurrection is positive when the patient has acute pancreatitis. A symptom of slip, also open to this scientist, is observed in the case of acute appendicitis.
