An acute attack of pancreatitis has, as a rule, a clinic consisting of some classic symptoms. The basis of the clinical picture of this disease during an exacerbation is pain syndrome. Pain usually pulling or cutting properties begins in the right or left hypochondrium, but with the growth of the area affected by the pancreatic tissue, the pain intensifies and acquires a shingling character. This syndrome is especially pronounced during periods of exacerbations and recedes somewhat during the period of remission. This sign of the acute form of the disease is due to the inflammatory process in the pancreas, as well as many concomitant causes, such as inflammation of the peritoneum, increased pressure and obstruction of the pancreatic pathways, squeezing the area in which the duodenum is located and much more.
The next sign of acute form is dyspeptic disorders. This section of the manifestations of acute pancreatitis is due to the general intoxication of the enzymatic organism, which is a consequence of the exacerbation of the disease. Therefore, all symptoms of poisoning are present in the clinic of pancreatitis. Another explanation for such symptoms in the clinic of such a disease as acute pancreatitis is that during the exacerbation of the inflammatory process, there is a concomitant lesion of certain parts of the stomach and intestines, which contributes to the overall picture of the disease.
The same clinic of acute form of pancreatitis includes signs of exocrine and intrasecretory insufficiency. In many cases, exacerbation of this disease is accompanied by a sharp loss of weight of the patient, this sign of the clinic of acute pancreatitis is associated with loss of appetite or weight loss due to a lack of insulin and the development of diabetes.
In some cases, the clinic for such a disease includes subcutaneous hemorrhages and bone pains, which are caused by a lack of certain fat-soluble vitamins in the period of exacerbation of pancreatitis in the human body.
Clinical picture of acute pancreatitis
Modern medical classification of clinical forms provides for the allocation of such variants of acute pancreatitis:
- edematous( dominates the swelling of the gland tissue without necrotic and hemorrhagic changes), is more common in young people;
- hemorrhagic or apoplexy of the pancreas( necrotic processes prevail and hemorrhages in the gland and surrounding tissues), characterized by severe course and high probability of death;
- purulent form( attachment of a secondary bacterial flora provokes the development of purulent inflammation of tissues), often occurs in elderly people.
The first and main sign of acute pancreatitis is pain. In different people, the threshold of pain sensitivity is significantly different, but the fact of pain at the very beginning of the disease is noted by all patients. Severity of pain varies from discomfort in the upper abdomen to unbearable pain. Localization of pain can also be different: mainly in the upper abdomen or right upper quadrant, less often - retrosternal pain resembling an attack of angina pectoris.
The clinical picture of the disease shows how the general condition of the patient changes. In the first hours of illness, general weakness and decline of strength is noted. Perhaps a slight increase or, conversely, a decrease in body temperature. A sharp rise in temperature to 38 ° C and above indicates the development of a purulent form of the disease or secondary purulent complications, in which case the risk of death is high. Skin covers of the patient are pale, in especially severe cases - with a cyanotic shade.
At the beginning of acute pancreatitis, the patient does not feel hunger, the appetite drops sharply until his complete absence. Trying to eat something by force can provoke vomiting. This symptom is observed in all patients, a single episode is possible, but more often - repeated. Often there is an indomitable and non-stop hiccup.
The abdominal changes will be examined in detail by the doctor, however, the patient may notice some points on his own. In the beginning there is a swelling of the upper part, then - of the entire abdomen. The tension of the abdominal muscles and the absence of respiratory movements of the abdominal wall are noted. The most pronounced these clinical symptoms in the period of the height of acute pancreatitis, which will be established in the course of an objective examination of the patient by a doctor.
It is necessary to pay attention to the clinical picture of acute pancreatitis from the respiratory and cardiovascular system, which indicates significant changes not only in the pancreas, but also in the whole body. As a result of significant disorders of the gland function, a severe intoxication syndrome develops. In this case there is a decrease in blood pressure and a decrease in the pulse. With the increase in the clinical picture, the bradycardia is replaced by tachycardia with unsatisfactory pulse characteristics. All this is combined with shortness of breath and peripheral cyanosis.
To confirm the diagnosis of acute pancreatitis in medicine, laboratory diagnostics of certain biochemical parameters of blood and urine helps, in particularly difficult cases - revision of the abdominal cavity, accordingly, treatment is prescribed.