Different methods of examination in determining the diagnosis allow the most accurate conclusion about the causes of impaired body functions. One of the common methods for suspected disruption of the various organs of the digestive system is palpation of the abdomen.
Symptom of Resurrection: clinical manifestations
During palpation of the abdomen in the epigastrium, it is determined that the patient has no or significantly weakened pulsation of the abdominal part of the descending aorta. This symptom is a characteristic sign of acute pancreatitis.
But Voskresensky's symptom is not pathognomonic. That is, similar phenomena may be evidence not only of acute pancreatitis, but also retroperitoneal hematoma, enlargement of some lymph nodes, etc.
Justification from a topographic-anatomical point of view
It is known that the pancreas is projected on the anterolateral abdominal wall in the epigastric region and on the left hypochondrium. The lowest part of the pancreas and the lower edgeare projected at a distance of about 5 cm above the location of the navel, and the upper one is about 10 cm above the navel. The location of the head of the pancreas is to the right of the VI-VII ribs, and the tail is to the left hypochondrium.
The retroperitoneal location of the head determines its close connection with the duodenum. Behind the pancreas is the abdominal descending aorta.
If there is no pathology, in the process of palpation of the abdomen in the epigastrium, aortic pulsation is easily determined.
The absence of pulsation in the abdominal region of the descending aorta in the presence of acute pancreatitis can be explained by the fact that enlargement and thickening of the pancreas leads to the fact that it obstructs a significant part of the aorta in front, which prevents palpation of its pulsation.
Other symptoms of pancreatitis
Symptom of Resurrection in pancreatitis is one of the most important manifestations of this particular disease.
Pancreatitis is an inflammatory-dystrophic disease of the pancreas tissue. It often occurs as a chronic form and has a rapidly progressive character. The final stage is characterized by the cessation of the pancreas from its functionality.
The most typical causes of this disease are:
- Frequent and excessive consumption of alcoholic beverages.
- Diseases of the biliary system (usually in women).
- A diet low in protein and fat.
- Hereditary pathologies,associated with impaired amino acid metabolism.
The predominant part of the complaints is associated with the occurrence of severe pain of various localization. Acute pancreatitis causes unbearable pain in the upper abdomen, radiating to the back. Chronic pain is less intense and sometimes feels like a heart attack.
Objective symptoms of pancreatitis, including Voskresensky's symptom, are not associated with the patient's pain threshold, so these signs become the main criterion in determining the diagnosis in this case. These also include a clear yellowing of the sclera of the eyes; the complexion of the patient changes from pale to sallow; eye sockets become pronounced; there is the appearance of bloody spots on the abdomen and in the inguinal region; the tongue is covered with a yellow coating; breathing quickens; severe pain occurs on palpation.
Examination methods for suspected acute appendicitis
In women, acute appendicitis is much more common than in men. It usually appears suddenly. There are severe pains in the epigastric region, intensifying and spreading throughout the abdomen. Then there is a localization of pain in the right iliac region (Kocher's symptom). Often there may be a single vomiting, stool retention. In some cases, diarrhea is also possible, which increases if the inflamed appendix is localized in the pelvic region. Possible irradiation of pain in the lumbar region or right leg, which is called"Shoe tying symptom."
If there are destructive forms, then pain relief and the appearance of chills are characteristic; increased heart rate and a slight increase in temperature. In this case, thirst arises, and the stomach remains the correct shape. Examination allows diagnosing lagging in breathing in the area of the right lower abdomen. There is hyperesthesia of the skin in the right iliac region, which is called Razdolsky's symptom. There are also clinical manifestations of the Crimean symptom, consisting in soreness in the process of feeling the right inguinal ring
The retrocecal location of the process in case of acute appendicitis provokes activation of the muscular protection in the area of the lumbar triangle (Petitov's symptom).
Slip (Voskresensky) symptom in acute appendicitis
The symptom is that the doctor, being on the right side of the patient, pulls his shirt down with his left hand, and carefully slides his right fingertips in the direction from the epigastric region to the right iliac. It is important, upon completion of the slide, not to immediately remove the fingers from the abdominal wall. The fact is that it is at the end of the slide that the patient feels a sharp pain. At the same time, when sliding in the opposite direction, pain does not occur.
The shirt symptom is a name that is often used in this case. But it is somewhat incorrect. It is more correct to use the term "slip syndrome".
When is this symptom positive?
So, Voskresensky's symptom is positive when the patient has acute pancreatitis. And the sliding symptom, also discovered by this scientist, is observed in the case of acute appendicitis.
