Pancreatitis is a serious pathology of the pancreas, which develops rapidly and, in the absence of timely treatment, leads to dangerous consequences. In ICD-10, acute destructive pancreatitis has code K85. With this disease, metabolic processes in the body are disturbed, and the pancreas begins to digest itself. As a result of this process, necrosis of the cells of the organ occurs. In the article, we will take a closer look at the symptoms and causes of this most dangerous disease.
What is this
Destructive pancreatitis is understood as inflammation of the pancreas, its tissues die off and are no longer restored. The organ swells and literally begins to devour itself. Pathology develops as a result of metabolic disorders. This leads to failures in the work of others.body systems, primarily the gastrointestinal tract.
Acute destructive pancreatitis begins with ordinary pancreatitis. This is always signaled by specific signs. The presence of pathology greatly affects the functioning of the human nervous system, up to the onset of coma. Without treatment, the disease progresses rapidly and at some point can lead to irreversible consequences. Statistics say that 25% of patients suffering from pancreatic necrosis (acute destructive pancreatitis) die.
Stages
Specialists identify several stages of pancreatitis:
- Enzymatic: within three days, necrotic changes develop in the tissues of the gland. Pancreatic enzymes are released from the cells, and cell membranes are destroyed under the influence of phospholipase A.
- Reactive: lasts from the second to the third week from the onset of the disease. The further course of the disease depends on the body's reaction to tissue death. The outcome will depend on whether the infiltrate resolves or cysts and abscesses form.
- Sequestration. According to the ICD-10, destructive pancreatitis has the code K85. This stage begins from the third week from the moment the pathology develops and lasts several months. During this period, fistulas and cysts are formed, internal bleeding, blood poisoning may begin. This is the most dangerous period of the disease, during which a fatal outcome is possible.
Forms of acute destructive pancreatitis
The disease hasthree forms, which depend on the intensity of the manifestation of signs and the degree of development:
- Toxemia: toxic substances that have a bacterial environment enter the bloodstream. This form is characterized by nausea, vomiting, and diarrhea.
- Abscess. Occurs when pus accumulates in tissues and organs. An abscess can form both in the pancreas itself and in neighboring organs.
- The next form of destructive pancreatitis is purulent changes both in the organ itself and in the retroperitoneal space.
Reasons
There are several known factors that lead to the development of such a deadly disease as pancreatic necrosis. The main ones are: alcohol abuse and gallbladder disease.
- Excessive consumption of alcoholic beverages is considered the most common cause of pathology. As a rule, the disease appears in people who abuse alcohol from five to fifteen years. However, cases of pancreatitis have been recorded with a single intake of alcohol, often in combination with fatty or fried foods.
- Cholelithiasis. Pathology develops due to blockage of the sphincter of Oddi with a stone, in connection with which bile begins to enter the pancreas. Another reason may be a blockage of the pancreatic ducts by a stone, which leads to the activation of enzymes in the gland itself.
Other reasons
In addition to the main factors affecting the development of the disease, there are several more reasons:
- Viral and infectiousdisease.
- Congenital pathologies of the pancreas.
- Injuries to this organ.
- The presence of parasites in the body.
- Taking lots of drugs.
- The consequences of surgical operations.
- Bites of poisonous insects.
- Poisoning by toxic agents.
Symptoms
There are three main signs that indicate malaise and the development of pancreatitis:
- bloating and flatulence;
- severe pain syndrome;
- nausea and vomiting.
Pain is felt in the left side of the body and back, can be given in the side or in the region of the heart. The pain is girdle and aching in nature, and may subside when the person is in the supine position, with the legs pulled up to the chest. As soon as the patient gets up, the discomfort returns. The intensity of the pain syndrome is individual: for some, the pain seems tolerable, and for others, it is exhausting.
Frequent vomiting leads to dehydration, which can lead to reddening of the face, pallor and loss of consciousness.
Also, with destructive pancreatitis, there are: elevated body temperature, increased heart rate and shortness of breath. There may be blue spots above the navel, on the buttocks and sides, yellowing of the eyeballs and a panic mood.
Diagnosis
Diagnosis of destructive pancreatitis is complicated by the fact that the symptoms of the disease are similar to those of other diseases. As a result, a thorough examination is required. AtSuspicions of an acute form of the pathology of the patient are taken to the hospital and, in addition to diagnosing, they provide emergency care.
Specialists identify the stage of pancreatitis, the degree of damage to the body and establish the root cause. For this, the following studies are carried out:
- doing blood and urine tests;
- using ultrasound to detect the size of the pancreas, its shape and the presence of fluid in the retroperitoneal space;
- degree of bloating of the intestinal section is detected by x-ray;
- to establish the presence of blood in the cavities and hemorrhages on the side of the abdomen, laparoscopy is performed;
- using computed tomography and MRI, areas of necrosis are detected, and the state of other organs is monitored.
Treatment
Most often the patient is admitted to the hospital at the stage of toxemia. After the research, the specialist makes an individual treatment of destructive pancreatitis. Most often, the disease has an unpredictable course, so the doctor must be prepared for different options for the development of pathology.
The following types of treatment are provided in a hospital setting:
- relieve pain;
- elimination of spasms and inflammation of the pancreatic ducts;
- prevention of inflammatory processes;
- removal of intoxication;
- heart-healing therapy.
Surgery may be indicated if medical treatment fails.
Operation
Surgical intervention fordestructive pancreatitis helps to restore the outflow of pancreatic enzymes and eliminate the necrotic area of the gland. Puncture-draining treatment is considered the most successful.
An operation is also prescribed in the case when the presence of stones, abscesses or cysts is detected.
Drainage is installed for the patient and dead areas are removed. Rarely, resection is required. The method of performing the operation can be puncture or laparotomy (with opening of the abdominal cavity) and laparoscopic, with the help of a puncture. Such operations are carried out no earlier than five days from the onset of the disease.
Diet
When diagnosing pancreatitis on the first day, a complete refusal of food is prescribed, while the patient must consume large amounts of water. It should be non-carbonated and clean, gradually water can be replaced with rosehip broth or fruit drinks.
After 3-5 days, soups and cereals on the water can be included in the menu, and subsequently the menu can be expanded. The diet has the following rules:
- refusal of forbidden food: fatty, fried, egg yolks, s alty, smoked, carbonated drinks, mushrooms, baked and sweet, coffee, chocolate.
- food should be fractional - four to six times a day, every three hours;
- dishes should be prepared by stewing, baking and boiling.
Dietary menu for destructive pancreatitis allows you to use:
- all kinds of boiled vegetable dishes;
- berries and fruits;
- mashed potatoes;
- cereal dishes;
- vegetariansoups;
- low-fat fermented milk products;
- lean fish;
- jelly, sweet juice, tea.
Complications
Untimely treatment of the disease can lead to such serious consequences:
- the disease can develop into a chronic form with enzyme deficiency;
- decrease in the amount of blood;
- shock;
- inflammation of the peritoneum;
- internal bleeding;
- purulent formations;
- anemia;
- blood infection;
- appearance of ulcers;
- blockage of venous vessels by a thrombus;
- growth of connective tissues - fibrosis.
The most common purulent inflammation, they appear together with tissue death or after 1-2 weeks.
The most common purulent complications. They can develop in parallel with tissue necrosis or after 1-2 weeks.
Forecast
Acute destructive pancreatitis is the most dangerous disease of the pancreas, which leads to serious consequences in the absence of timely treatment. In advanced cases, without therapy, the pathology is fatal.
The wrong lifestyle leads to the development of pancreatic disease:
- snacking on the run;
- junk food;
- smoking;
- reception of alcoholic beverages;
- ignoring infectious diseases in the body.
The following factors also influence the outcome of the pathology:
- degree of impactenzymes on tissue;
- presence of local and systemic complications;
- age of patient;
- presence of comorbidities;
- size of necrosis focus;
- timeliness of operation.
The saddest prognosis is observed with the following symptoms:
- old age, over 50;
- high white blood cell count;
- diabetes mellitus;
- high concentration of urea;
- high activity of liver enzymes;
- dehydration.
In severe cases, the probability of death rises to 50%. Early therapy reduces risks and improves prognosis.
With timely access to a specialist, pancreatitis can be successfully treated. To do this, you need to visit a gastroenterologist every six months, who will be able to identify the presence of any disorders in the body in time and prescribe the necessary treatment.
