Instrumental and laboratory diagnostics of early complications in acute pancreatitis

The aim of the study. Assessment of markers of early complications in patients with acute pancreatitis. Materials and methods. Observation was carried out for 151 patients who were in the clinic from 2011 to 2019, with a diagnosis of acute pancreatitis (OP). The average age of patients (47.8±1.5) years. The patients were divided into 2 groups: group I - 78 patients with developing pancreatic pseudocyst (PP) and group II - 73 patients with free fluid accumulations (FFA) of the abdominal cavity. All patients underwent comprehensive examinations, including histology of emerging cysts, clinical and biochemical blood tests, sonography and computed tomography, bacteriological and enzyme immunoassays with assessment of the level of endogenous intoxication, procalcitonin, microbial contamination and cytokines. Results. In comparison with group I patients with developing PP, the observed group II patients with FFA showed a significant increase in the degree of endogenous intoxication. A 3.0-fold increase in the level of procalcitonin in 26.8% of group I patients and in 67.1% of group II patients (p<0.05) with a directly proportional dependence of this indicator on the level of bacterial contamination (r=+0.51; p<0.05) indicated the activation of infection processes in general and, to a greater extent, in group II patients. At the same time, the condition of their last worsened due to the transition of the inflammatory process to the parapancreatic region and into the retroperitoneal space. The high level of proinflammatory cytokines IL-6, TNF-α in patients of group II compared with group I, an imbalance and a decrease in the activity of the anti-inflammatory mediator IL-10 determined a significantly greater (p<0.05) activity of the inflammatory process in patients with SFS, and were associated with an unfavorable prognosis. Conclusion. The formation of a PP is a relatively favorable outcome of acute pancreatitis, accompanied by significantly less pronounced toxemia and infection rate in comparison with patients with free fluid accumulations of the abdominal cavity.

acute pancreatitis, pancreatic pseudocyst, pancreas, fluid accumulations, sonography, procalcitonin, microflora, cytokines

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