Differential( diff) diagnosis of the pancreas: pancreatitis - formulation and formulation

Pancreatitis is considered one of the most difficult in the diagnosis of the disease. However, it is very common among other diseases of the gastrointestinal tract. The disease manifests itself is very diverse, therefore it is very difficult to put a differential diagnosis even with the help of laboratory tests.

Pancreatitis is a very unpredictable disease that carries a real threat to human life. Differential diagnosis of "pancreatic pancreatitis" is most often based on anamnestic data, which is a combination of the clinical picture, laboratory, as well as X-ray studies. The main and frequent symptom of pancreatitis is severe pain in the abdomen. It can be different - moderate, strong, permanent. Can give in the back, chest, hand, in the lateral parts of the trunk, in the lower abdomen. It is difficult for patients to lie in the supine position, as the pain becomes worse. Nausea, vomiting, flatulence are also common symptoms of pancreatitis pancreatitis. Skin and mucous patients are most often pale. When squeezing the bile ducts, jaundice is detected. This is due to the fact that the pancreas is greatly enlarged due to the presence of inflammation. As a result of laboratory studies, pancreatic pancreatitis can be reported by revealed anemia, leukocytosis, lymphopenia, increased ESR.The concentration of bilirubin in the blood can also increase.

As a result of X-ray examination, patients are diagnosed with a high diaphragm position. It becomes immobile, often it accumulates liquid. Laparoscopy is important for diagnosis. This procedure will help to dispel doubts in the formulation of a correct differential diagnosis, will perform a complete audit of the abdominal cavity, find out the status and dimensions of the pancreas and bile ducts. If the pain is unbearably severe, do not exclude the possibility of acute pancreatitis. In his favor, evidence of persistent severe pain in the abdomen, nausea, vomiting.

The diagnosis is considered reliable after the results of laboratory studies, in which an increase in the activity of lipase or amylase in serum is detected.

It is important to put the correct differential diagnosis, which will exclude other diseases with similar symptoms. They can be intestinal obstruction, acute cholecystitis, appendicitis, acute gastritis, myocardial infarction, renal colic and other diseases.

Statement and wording of diagnosis

When diagnosed as "pancreatitis," experts will identify several major categories of the disease. The clinical picture implies the division of the disease according to necrotizing and interstitial signs. The underlying cause of this classification is the results of ultrasound and CT.

Many gastroenterologists, when formulating the diagnosis of pancreatitis, use the method of Balthazar-Banks, based on the allocation of 5 main points in the pathological development of the pancreas:

  • Contrasting the gland.
  • Abnormal increase in organ size.
  • Peripancreatitis characterized by inflammatory tissue disorders.
  • Presence of fluid formations in pararenal space.
  • Presence of liquid formations in a stuffing box.

The diagnosis of "pancreatitis", in the first stage of the disease, is rather complicated and requires repeated confirmation by fixing changes in the general analysis of blood and pathological disorders of the pancreatic tissue. Only with the final confirmation of the correctness of primary results, a specialist can begin to work out and formulate a version of the predicted diagnosis.

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