The pancreas is one of the largest glands in the digestive system, inferior in size to only the liver. The organ, consisting of the tail, body and head, is located near the liver, stomach, kidneys, spleen - the most important organs of the human body. Therefore, the inflammatory processes occurring in the pancreas are often a reaction to exacerbation of chronic diseases of the abdominal cavity, which were triggered by alcohol abuse or abundant, but rare methods of oily and spicy food.
For example, digestive gastric juice, which is produced by the parenchyma, accumulates in a single duct connected to both the duodenum and the gallbladder. Therefore, diseases of the bile duct and liver are instantly reflected in the pancreas.
Inflammation of the pancreas due to the aggressive effects on it of other organs is called an attack of reactive pancreatitis, which is characterized by an increase in the size of the organ caused by edema, as well as changes in the density state and reactive changes in the parenchyma - pancreatic tissue. Such reactive changes in the inflamed organ in most cases lead to pain syndrome, digestive disorders and increased blood sugar levels.
This condition is due to the fact that the glandular tissue of the parenchyma in the reactive pancreas in insufficient quantity produces both pancreatic juice containing digestive enzymes and hormones responsible for lipid-carbohydrate metabolism.
Allergic reaction is one of the most common causes that can trigger reactive changes in both size and condition of the parenchyma of the gland.
Pathological changes in the pancreas are diagnosed by ultrasound. On ultrasound the parenchyma of a healthy pancreas is uniform, without visible increases and decreases in the size of the organ, without diffuse changes and foci. When pancreatitis the doctor looks not only at the gland, but also all the digestive organs that could cause the attack.
Very often in concluding the results of ultrasound can be found the term "diffuse changes" of the organ. This is not a diagnosis, but the result obtained, a study that indicates that the reactive changes have evenly spread throughout the pancreas and there are no local foci in the organ indicating neoplasms or the presence of stones.
US: diffuse reactive changes in the pancreas
Diffuse reactive changes in the diseased organ can be different, their nature helps to establish the diagnosis of the disease. And if it is pancreatitis, clarify its form:
- diffuse decrease in parenchyma density, as well as a decrease in echogenicity of the ability of the tissue to reflect ultrasound( echogenicity) and increase in the size of the pancreas, most often occurs with an attack of acute pancreatitis. If there is a violation of the outflow of gastric( pancreatic juice), which begins to digest the tissue of the organ itself. The gland swells and grows in size;
- diffuse decrease in parenchyma density, decrease in echogenicity without increasing the size of the organ indicates chronic reactive changes;
- for pancreatic fibrosis in the conduct of ultrasound is characterized by an increase in diffuse echogenicity and organ density at a normal or reduced size. This occurs most often with inflammatory processes or metabolic disorders, when the healthy tissue of the parenchyma is replaced by a connective tissue.
Pancreas reaction
The very term "reactive changes" means that they develop as secondary against a backdrop of diseases of the digestive system, as their normal functioning is closely related to the operation of the pancreas. Its juice has an alkaline reaction( from 7.6 to 8.5), which is due to the content of sodium bicarbonate in it.
Development of reactive pancreatitis can be a pancreatic reaction to the following gastrointestinal diseases:
- chronic cholecystitis - causes diffuse changes, since the pancreas and gallbladder are connected by a common duct;
- chronic and acute hepatitis - cause disruption of the production of bile, which may result in the development of reactive pancreatitis;
- exacerbation of duodenal ulcer;
- spreading of peptic ulcer in the gland head;
- diseases of the esophagus, developing as a result of reflux( the return of the contents of the stomach into the esophagus);
- the presence of ulcerative colitis.
Reactive changes that develop against the background of gastrointestinal diseases occur with minimal clinical signs or asymptomatic. In the diagnosis of the disease, in addition to ultrasound, a blood and urine test is required to determine the enzyme content. Reactive changes do not require specific therapy, after the treatment of the underlying disease they pass by themselves.