Inflammation of the pancreas is called pancreatitis. But in order to reliably establish the diagnosis, differential diagnosis must be carried out. Pancreatitis can be acute or chronic. It is important to know its characteristic features in order to distinguish it from other diseases of the gastrointestinal tract.
Similar diseases
You can choose the most appropriate treatment tactics if you know the exact diagnosis. For this, differential diagnosis of pancreatitis is carried out. It is important to be able to distinguish this disease from a number of others that are similar in symptoms. These diseases include:
- pancreatic cancer;
- peptic ulcer (perforated ulcers);
- cholecystitis;
- intestinal obstruction;
- acute appendicitis;
- myocardial infarction.
Determine what kind of problem caused certain symptoms, as a rule, you can only in the hospital. Doctors need to know the characteristic features of all diseases in order to make an accurate diagnosis.
Differentialdiagnostics
It is possible to detect a tumor in 85% of cases with the help of computed tomography. But the best way to differentiate between cancer and pancreatitis is to use ERCP - endoscopic retrograde cholangiopancreatography.
Distinguish pancreatitis from a perforated ulcer by the behavior of the patient. In the first case, he will try to take one position and not move. With pancreatitis, patients are restless. In addition to pain, they also experience vomiting.
You can figure out what exactly worries a person with the help of ultrasound. This study makes it possible to diagnose cholecystitis. With this disease, patients complain of pain on the right side, which passes into the corresponding shoulder. An inflammatory process is visible on ultrasound with cholecystitis.
Intestinal obstruction manifests itself in the same way as pancreatitis. These diseases can be distinguished by blood tests. For this, the diagnosis of pancreatitis is carried out. Analyzes will show diastasis and elevated chloride levels with inflammation of the pancreas.
Classification of pancreatitis
To understand how inflammation of the pancreas manifests itself, one must understand that it can be acute or chronic. In the first case, the symptoms are pronounced, it is easy for the doctor to understand that the patient has acute pancreatitis. Diagnosis is mandatory, and only after confirming the doctor's assumptions (using ultrasound and tests), treatment is prescribed.
Chronic pancreatitis is characterized by alternating periods of slight improvement/worseningstates. In this case, the inflammatory process is sluggish. But it leads to atrophy of the gland tissues.
Characteristic of acute inflammation
Laboratory diagnosis of pancreatitis is necessary to determine the severity of the disease. Acute inflammation may be mild. In this case, organs and systems are affected minimally. The disease is expressed in the swelling of the gland. This type of pancreatitis is easily treated and patients recover quickly.
In a severe form of an acute inflammatory process in the pancreas, pronounced disorders are observed in various organs and tissues. In addition, a severe form may be accompanied by such complications:
- pancreatic abscess (pus accumulates in the pancreas or surrounding tissues);
- acute pseudocyst - occurs 4 or more weeks after an attack of pancreatitis, characterized by the accumulation of pancreatic juice;
- pancreatic necrosis (possible tissue infection as well);
- acute accumulation of fluid in the peripancreatic space or in the gland itself.
This must be taken into account when diagnosing. Pancreatitis, in which tissue necrosis has begun, can cause death. This occurs, as a rule, with the development of a purulent form of the disease.
Chronic inflammation options
Specialists distinguish two subspecies of chronic pancreatitis. It can be primary or secondary. In the first case, inflammationstarts directly in the pancreas. Secondary chronic pancreatitis develops against the background of other diseases of the digestive system. He is a complication.
In this disease, inflammation can either decrease or begin to develop with renewed vigor. But this is not as harmless as it might seem at first glance. A competent diagnosis of chronic pancreatitis is necessary, because tissue atrophy can begin with it, the pancreas calcifies over time, its normal tissues are replaced by scars.
Symptoms of acute pancreatitis
You can figure out when you need to see a doctor if you know the signs of the onset of an active inflammatory process. These include a pronounced pain symptom. Most patients point to the epigastric region (left hypochondrium). The pain is girdle, it can give to the region of the left shoulder blade. In the supine position on the back, it only intensifies. Deterioration is observed after taking alcohol, fatty, fried or spicy food.
In addition to pain, there are other signs that indicate that acute pancreatitis has begun. Diagnosis and treatment should be carried out in a hospital setting. This will allow you to establish the diagnosis as accurately as possible and reduce the time required to restore he alth. The symptoms of this disease are:
- rising temperature;
- vomiting that does not bring relief (may be uncontrollable);
- moderate yellowness of the sclera, in some patients the skin may look yellowish;
- hemorrhages in the navel, bluishspots on the body;
- heartburn;
- bloating, flatulence.
Also, the disease is evidenced by a violation of the stool, the appearance of excessive fatigue, a decrease in pressure, pallor of the skin and increased sweating. Patients often complain of dry mouth and a white coating on the tongue on examination.
Signs of chronic inflammation
Understand that you have problems with the pancreas, you can not only by indomitable vomiting and severe pain. Some people may suffer for years and not realize that they have chronic pancreatitis. Diagnosis and treatment will be complete if the patient goes to the hospital in a timely manner.
The development of chronic pancreatitis is evidenced by:
- recurrent pain localized in the left hypochondrium, often they radiate to the back;
- periodic feeling of nausea;
- diarrhea, in which a characteristic odor appears;
- dramatic weight loss;
- feeling worse after eating fatty, fried, smoked food.
If pancreatitis is not treated, then the patient develops weakness, dizziness. Some may even develop type 2 diabetes, memory loss, and breathing problems.
Laboratory diagnostic methods
When patients with suspected pancreatitis are admitted, they are assigned a comprehensive examination. First of all, a biochemical blood test is done. It allowsdetermine the type of disease, thanks to this test, the diagnosis of pancreatitis is more accurately carried out. Analyzes make it possible to clearly present the picture of the disease.
With inflammation of the pancreas, the level of alpha-amylase, lipase increases, the activity of C-reactive protein sharply increases. If the disease is accompanied by a malfunction of the kidneys, then the level of urea in the blood increases. At the same time, you can see a decrease in the amount of proteins, including albumin. There is also a noticeable decrease in the amount of insulin, which causes the level of glucose to rise.
Water and electrolytic analysis allows you to determine how much the composition of the blood has changed. A decrease in fluid levels can cause blood clots and blockage of small vessels. Also, this analysis allows you to determine the concentration of minerals: potassium, sodium, calcium. They are responsible for the normal functioning of the heart and blood vessels.
Complete blood count gives an idea of the nature of the disease. Pay attention to the level of leukocytes and erythrocytes. Without this examination, a full diagnosis cannot be carried out.
Pancreatitis is also established by urinalysis. In this disease, the level of alpha-amylase significantly deviates from the norm. But this is observed only in the initial stages of the disease. With the progression of pancreatitis, erythrocytes, leukocytes and other components can be detected in the urine.
Instrumental diagnostics
Methods for diagnosing pancreatitis are quite diverse. In addition to examining biological fluids, the doctor needs to see exactly how the pancreas has changed. Alsoit is necessary to establish whether its inflammation has affected the surrounding organs and tissues.
The most accurate and effective is ultrasound diagnostics. It allows you to visualize the gland, to see if there are inflammatory processes, if the tissues of this organ have become smaller. Diagnosis of chronic pancreatitis can also be made using ultrasound. This disease can be determined even in the asymptomatic period. Ultrasound also allows you to examine the bile ducts, determine the beginning of purulent abscesses and see the fluid.
Laparoscopy allows you to simultaneously diagnose and treat pancreatitis. In some cases, during this mini-operation, it is possible to minimize the negative impact of inflammation on other organs. But laparoscopy is used only in extremely severe cases.
Computed tomography can also be used to diagnose. Pancreatitis can be identified by characteristic signs: an enlarged pancreas, the presence of inflammation and dead tissue.
Endoscopy allows you to see all the changes in both the pancreas and the duodenum. To do this, an endoscope with a camera mounted on it is inserted into the esophagus.
