The pancreas is located behind the peritoneum onlevel I-II of the vertebral segments of the lumbar spine. This body is involved in the most important processes in the body. Next, we will understand what his functions, what may be violations in his activities. In particular, we consider how acute pancreatic necrosis is manifested.
General information
Pancreas (normal size:15-10 cm - length, 2-3 cm - width) is considered to be a rather large organ. Its weight in an adult is about 100 g. At birth, its mass is not more than three grams. In humans, the body performs two important functions. Consider them in more detail below.
Functions of the body
External secretion of the pancreas hasvalue for the duodenum - it is allocated pancreatic juice. It contains enzymes: amylase, lactase, maltase, lipase, trypsin and others. Due to the pancreatic juice, the acidic gastric contents are neutralized and food is digested. Initially, enzymes are produced in an inactive form, activating subsequently in the duodenum. Their action is aimed at splitting carbohydrates, fats, proteins into the main components.
Ducts
Inside the gland passes a channel opening induodenum. The common bile and pancreatic ducts in most cases form an ampoule. As a result, they open up in the large nipple of the duodenum. Normally, the pressure in the pancreatic ducts should be higher than in the common bile duct. This is due to the need to prevent the release of intestinal contents and gallbladder.
Violations of the body
With changes in the pressure difference in the pancreashypertension appears. It is associated with obstructed outflow of pancreatic juice, the discharge of the contents of the gallbladder or intestines. Against the background of increasing pressure, the own pancreatic cells begin to get damaged. Of these, enzyme compounds are released and activated. They penetrate the parenchyma, adipose and connective tissue of the gland. As a result, a chain reaction occurs. Through one enzyme, another is released. This provokes an inflammatory process, leading to increased blood circulation, and subsequently - to stagnation of blood. It promotes thrombosis in the gland. As a result of circulatory disorders, pancreatitis occurs, often provoking pancreatic necrosis.
Causes of disruption
A pathological condition usually appearsas a result of postponed single or repeated attacks of pancreatitis. The acute form is directly interrelated with gallstone disease. The provoking factors are an ulcer (of the stomach or duodenum), cirrhosis, hepatitis, and alcoholism.
Important information
As mentioned above, to one of the functions of the glandrefers to intrasecretory hormone production. The islets of Langerhans are involved in this task. In case of their defeat against the background of pathologies, including pancreatitis in a chronic course, fatty degeneration in the liver and diabetes (sugar) develop. The pancreas is able to adapt to the type of food. It all depends on the food you eat. When a large amount of carbohydrates is taken in, more enzymes that break them down are activated. If fat food prevails, then more lipase is produced, and if protein foods - trypsin. However, these features should not be abused. The fact is that the pancreas rarely signals a possible overload. As a rule, a rather violent reaction is manifested, which indicates not its initial stage of pathology, but its full bloom.
The consequences of neglected diseases
Neglect of the statepancreas can trigger various complications. The danger lies mainly in the fact that next to it are other organs that are of no less importance to the body. This, in particular, the spleen, liver, stomach. Do not stand aside and heart. When disorders in the activity of the pancreas, this organ is also subjected to stress. Changes in the work of systems occur very quickly. For the pancreas, sometimes several hours are enough.
Acute necrosis of the pancreas
This process is a tissue death.body. Its development is affected by various traumatic factors. At the heart of them is inflammation of the body. Acute necrosis of the pancreas develops in case of delaying its examination and treatment. The process is actively involved own organ enzymes. Under their action, pancreatic digestion occurs. When activated, interstitial enzymes progress pathological processes. As a result, foci of necrosis are formed.
Process description
As a result of the breakdown of fatty acids,pH shift. At the same time, intracellular trypsogen is activated. Subsequently, it is transformed into trypsin. This compound, in turn, activates proteases that form certain proteolytic foci. Enzymes begin to erode the vascular walls and connective tissue. The destructive process extends beyond the pancreas. The restoration of the body in this case becomes impossible. If there are clear signs of death, it can be instantaneous.
The provoking factors
Некроз поджелудочной железы, симптомы которого will be discussed below, most often the result of excessive alcohol consumption, overeating, dyskinesia in the biliary tract, disorders of enzyme outflow against the background of cholangitis, calculous cholecystitis. Disease medication, dose violation and regimen can cause pathology. Acute necrosis of the pancreas may be due to frequent infectious diseases, stress.
Pathology pathology
Depending on the area of distribution, acutenecrosis of the pancreas can be extensive and focal. The process can progress rapidly or flow rather sluggishly. In accordance with the type of pathological course, pancreatonecrosis is divided into destructive, functional, hemostatic, hemorrhagic and edematous. The latter is considered the softest form. Due to puffiness, the pancreas is enlarged, which provokes an increase in pressure on pancreatocytes and microcirculation disorder. Treatment of the edematous stage is usually successful. When untimely referring to a specialist pathology takes a more neglected form. In particular, the necrotic process disrupts the outflow of digestive enzymes from the pancreas. As a result, the body begins to digest from the inside. As the process progresses, pus penetrates the abdominal cavity. As a result, acute peritonitis develops. In this case, surgical intervention is inevitable. Otherwise, sepsis will begin, leading to death.
Clinical picture
How does pancreatic necrosis manifest?Symptoms of pathology are quite intense. In the left hypochondrium develops soreness shingles character. It spreads all over the body below the ribs. The pain gives to the shoulder and shoulder blade, as in a heart attack. The processes are accompanied by abundant vomiting, bloating, flatulence. The patient has a fever, the skin turns pale or red. The main symptom of a pathological condition is considered to be Gray-Turner's symptom. It manifests itself in the form of cyanotic spots from the sides of the abdominal cavity. On palpation of the wall there is pain, tension. Diagnosis is carried out on the basis of visual inspection, patient complaints, and also based on the results of instrumental and laboratory research. To assess the echogenicity of the parenchyma is assigned an ultrasound. CT and MRI, angiography and laparoscopy allow to establish the exact onset of the disease.
Therapeutic events
Treatment of acute necrosis can be eithersurgical as well as conservative. The choice will depend on the pathological changes in the body. Medication is prescribed individually. Among the drugs recommended for administration are antispasmodics (No-shpa, for example), anti-enzyme and cytotoxic drugs that affect enzyme synthesis. From surgical methods used laparotomy and laparoscopy. However, during the operation it is not always possible to eliminate the pathology completely. In general, patients are treated in a hospital setting.
