Pancreatic necrosis affects a significant part of the organ, as a result of which initially high excretion activity will decrease to a level of hypofermentemia or afermentemia. For diagnosis in pancreatic necrosis, it is very important to determine the level of alpha-amylase activity in urine and blood. This value usually within a few hours after the onset of the disease should exceed the normal value by almost half.
Conducting a subsequent diagnosis on the third day of the course of the disease makes it possible to determine whether a pancreatonecrosis in a patient takes on a progressive or abortive nature. In case of a favorable combination of circumstances and the appearance of necrosis of abortive nature, the upper limit of the enzymatic activity will exceed the norm by 2.5 times, with the pancreonecrosis of the fatty type the indicator will be 3 to 5 times, in the case of hemorrhagic disease this figure may exceed the norm by 9 times.
If the conclusions about the abortive form of pancreonec
rosis made on the third day are correct, then on the ninth day after the illness, the activity of alpha-amylase will be within the normal range. But since the defeat by necrosis of a large pancreas region can also lead to a normal level of enzymes from the analysis, since most of the organ that produces alpha-amylase has already died out and can not produce enzymes, it is necessary to resort to other methods for studying pancreatic necrosis for a full diagnosis.
To determine the presence of edema and the structure of the gland on the heterogeneity, it is possible to use ultrasound as a method for diagnosing pancreatic necrosis. A no less popular method for studying the patient's condition in this disease is computed tomography. In pictures taken for the diagnosis of pancreatic necrosis, the affected gland will not be displayed, but its shadow will become heterogeneous and intense.
For a complete picture of the development of pancreatonecrosis, one can use this method of diagnosis as a celiacography. By results it is possible to find out: disappearance or weakening of the shadow of intraorganic vessels of the gland, upward shift and angular deformation of the common hepatic artery, pushing to the right side of the gastroduodenal artery. The presence of such abnormalities and will indicate a correct preliminary diagnosis of pancreatic necrosis.
If there is any doubt in the correctness of the diagnosis, a laparoscopy or diagnostic laparotomy is performed.
Ultrasound of pancreonecrosis
At the stage of pancreatic necrosis, the diagnosis is made by the method of taking samples, and further treatment is directly related to constant monitoring on the ultrasound machine. This is due to the fact that after treatment of the disease in the pancreas of the patient may occur infiltration. Determine its occurrence is impossible, because blood tests do not show any changes. The patient does not feel deterioration of health. However, for some indirect signs, an experienced doctor can detect a violation, ultrasound is used to confirm the diagnosis.
Apparatus ultrasound is often used both in the treatment of pancreatonecrosis, and during rehabilitation. It is absolutely safe for the patient, allows you to monitor disease in dynamics. Ultrasound does not give the patient any pain and shows excellent results in the diagnosis and treatment of the pancreas.
MRI diagnosis of pancreatonecrosis
More modern and technologically equipped clinics use MRI studies. They are more accurate and allow you to follow the course of the disease without harm to the patient. However, the method of MRI examination is effective only in the initial period, that is, at the early stage of the disease, after the operation this technique of research is not used in view of its inefficiency and a large number of difficulties associated with the delivery of the patient to the place of examination.
Based on the above data, it can be concluded that ultrasound and MRI diagnostics are necessary during the treatment of pancreatic necrosis. Each of the methods of research is used at a certain stage of the disease course. If the MRI is most effective during the initial stage and the development of the disease, ultrasound can detect abnormalities and complications in the postoperative period.