Total hemorrhagic pancreatic necrosis refers to a severe or extremely severe degree of the disease, in which 90 to 100% of the retroperitoneal tissue is affected by two lateral canals, right up to the ileum. With a severe degree of pancreatic necrosis, the patient's condition continues to worsen within 1-3 days even with massive infusion therapy, and signs of the onset of multiple organ failure and pancreatogenic shock can be added to the progressive total syndrome.
In the analysis of the patient's blood for total hemorrhagic pancreonecrosis, there is a marked increase in leukocytes, which occurs due to a large number of neutrophils, and sometimes leukocytosis. In the usual forms of leukocytosis, the release of pancreatic enzymes does not occur in the intestine as it should be normal, but accumulates due to a swelling in the intercellular space of the pancreas, and from there the enzymes enter the blood and are excreted in the urine. Due to this, the patient's blood usually has an increased amount o
f pancreatic enzymes, which is used in the diagnosis of this disease. There is a glycemia of the diabetic type, when the sugar in the blood contains more than 10 mmol / l, the serum calcium is less than 2 mmol / l, and the level of the average molecules exceeds 0.5 cu.and in the serous cavities dehydration of a severe degree.
Analysis of the patient's blood for total hemorrhagic pancreatic necrosis, which is in extremely serious condition, to the above listed is added rapidly developing multi-organ failure and terminal state. But since total pancreatic necrosis leads to the death of most pancreatic cells, enzymes will not enter the bloodstream and the content of diastase in the urine may not go beyond the normal values or even decrease, and the lack of insulin production and defeat of the cells of the islet system will lead to the appearance of glucosuria andhyperglycemia.
The most promising type of treatment for total necrosis is an early radical surgery: pancreatectomy, resection of the gland, sequestrectomy. The first two operations should be recommended to patients whose active complex treatment was ineffective, and the necrotic process continues to progress.
Subtotal pancreatic necrosis
Subtotal pancreatic necrosis is a stage of complicated acute pancreatitis, in which the pancreas collapses, that is, the parts of the gland are affected, namely the body, head and tail. With this form of the disease, about 60-70% of pancreatic tissue dies. The reason for this is the thrombi arising from the disturbance of the microcirculation of the blood vessels, when the supply of nutrients to the gland is limited, resulting in the complete death of its cells. After mandatory surgery, the patient undergoes rehabilitation and follows the instructions of a specialist to avoid complications and repeated "outbreaks" of the disease.
Preventing the development and exacerbation of subtotal pancreatic necrosis is the complete elimination of alcohol and proper nutrition with a diet. For example, to limit the amount of oil( vegetable and cream) and eggs consumed, to refuse baking( you can only dry bread).From meat and poultry choose low-fat varieties in boiled form, as a side dish - vermicelli, rice, buckwheat, grated potatoes and vegetables( zucchini, carrots, pumpkin).As for drinks, it is allowed to have loose tea and compote from dried fruits, not adding sugar.