DEVELOPMENT OF PARAPANCREATITIS DEPENDING ON THE CONFIGURATION OF INJURY OF THE PANCREAS AT ACUTE NECROTIZING PANCREATITIS
Abstract
223 patients with acute necrotizing pancreatitis were examined. The conclusion about the nature of defeat was based on clinical, laboratory and instrumental data. Assessment of a condition of a pancreas was carried out on the basis of the KT-angiography with contrasting on 9 [7; 14] days from the beginning of a disease. Further conducted the dynamic research. Spread of parapancreatitis estimated according to classification of K. Ishikawa. Determined blood α-amylase level at receipt and α-amylases of the exudate received during a drainage of the acute liquid congestions (ALC), the level of the homocysteine, the level of C-reative protein. At patients the right type of injury of a pancreas - 67,71±3,13% of cases prevailed, the left type was observed in 13,45±2,28% of cases, and multiple damage - 18,83±2,62% of cases. At deep right type of a pancreatonecrosis in 62,91±3,93% of cases observed existence of the isolated functioning sites of a head of a pancreas which lost anatomic communication with a pancreatic channel. At the left type - 23,33±7,72% of cases. At a multiple necrosis - in 61,90±7,49% of cases. In the presence of the isolated site in all cases widespread parapancreatitis was created. ALC in the presence of the isolated site are formed in earlier terms - 19 [16; 21] days from the beginning of a disease also have high enzymatic activity of a α-amylase - 2540 [2130; 2620] piece/l. The right type of damage of a pancreas prevails. At deep defeat of an isthmus the isolated site of the functioning parenchyma of gland and internal pancreatic fistula is formed that is characteristic of the right type and multiple damage of a pancreas. At the left type of a pancreatonecrosis formation of the isolated site perhaps in rare instances of a deep necrosis of a body of gland. Existence of the isolated site of a parenchyma leads to formation of widespread parapancreatitis with early formation of ALC which are characterized by high enzymatic activity.
About the Authors
S. S. Dunaevskaya
Krasnoyarsk State Medical University named after prof. V. F. Voyno-Jaseneckiy
Russian Federation
Russian Federation
D. A. Antufrieva
Krasnoyarsk State Medical University named after prof. V. F. Voyno-Jaseneckiy
Russian Federation
Russian Federation
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For citations:
Dunaevskaya S.S., Antufrieva D.A. DEVELOPMENT OF PARAPANCREATITIS DEPENDING ON THE CONFIGURATION OF INJURY OF THE PANCREAS AT ACUTE NECROTIZING PANCREATITIS. Experimental and Clinical Gastroenterology. 2018;(3):71-77. (In Russ.)
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