Chronic reactive pancreatitis

By pancreatitis is meant an acute or long-lasting (chronically) inflammatory process in the pancreas. The disease can appear primarily. Also separately isolated reactive pancreatitis, which develops against the backdrop of long-term, chronic diseases of the digestive system. Such inflammation is formed in the presence of chronic cholecystitis, stones in the bladder, with regular errors in nutrition and chronic alcoholism, with ulcerative lesions of the stomach or duodenum. Reactive pancreatitis can occur with infectious diseases, helminthic invasions, atherosclerotic lesions of pancreatic vessels, chronic intoxication in harmful production.

Pathological processes occurring in the pancreas in pancreatitis

Exacerbation of pancreatitis causes edema of the body and a violation of the outflow of secreted juice. At the same time, the tissue of the gland is destroyed (autolysis) and the replacement of the glandular structure by a cicatrical connective tissue.

If the cause of inflammation is an infectious agent, it enters the pancreas through its ducts or with blood.

Inflammation can develop with a tumor of the duodenal nipple. In this case, there is a violation of the normal current of pancreatic juice and as a consequence - the development of inflammation.

The pathological process can only capture part of the body or spread to the entire gland (diffuse pancreatitis).

In medicine, the following types of reactive pancreatitis are distinguished: edematous, parenchymal, calculose and sclerosing.

Symptoms of pancreatitis

Exacerbation of the disease is characterized by the appearance of soreness in the area of the projection of the stomach, the left hypochondrium. Pain can be given in the back, hand and wear around the circumference. Sometimes such pain can be taken for an attack of angina pectoris. There is a general malaise, dyspepsia (nausea, vomiting), a stool. The patient may complain of chills and subfebrile temperature. Exacerbation of pancreatitis may have a clear dependence on food intake and on the aggravation of other diseases of the digestive tract. The pain is unceasing or paroxysmal. Very often, the Mayo-Robson symptom (pain in the rib and vertebral corner to the left) is positive.

Reactive pancreatitis causes a persistent loss of appetite and impaired digestion. Such patients are often depleted. A long-term inflammatory process can lead to diabetes mellitus. Disturbances of absorption cause disorders of the stool, it becomes undigested and fetid (pancreatic diarrhea), hypovitaminosis occurs.

Diagnostics

Reactive pancreatitis is characterized by the presence of any concomitant disease of the digestive system, i.e. There is a clear link with the exacerbation of this disease.

In the blood there is a moderate anemia, an increase in leukocytes and ESR, a violation of the protein composition of the blood.

If reactive pancreatitis causes the appearance of diabetes, then sugar in the blood increases and there is an increased secretion in the urine. There is a violation of the metabolism of electrolytes. There is an excessive increase in pancreatic enzymes in the blood.

At an ultrasound examination, the pancreas can be enlarged due to edema, its echogenicity is also increased, the contours are uneven. With advanced stages and a long course, the dimensions can be reduced, on the contrary, and the glandular tissue is replaced with scar tissue. A more accurate picture and localization of the inflammatory process can be provided by computed tomography.

Treatment

With an exacerbation of pancreatitis, treatment is best performed in a hospital. It is important to eliminate the original cause of the disease. The patient should follow a strict diet with sufficient intake of protein. The food is excluded from aggressive food and alcohol. Anti-enzyme preparations are prescribed. According to the indications, antibacterial therapy is used. Introduce antispasmodics and pain medications. In particularly severe cases, surgical treatment may be required.