During the examination of the gastrointestinal tract, in particular the pancreas by ultrasound, for a more simple, understandable classification, use the visual characteristics: white, light, motley and black.
White pancreas occurs when an acute, aseptic inflammation of the pancreas - acute pancreatitis. This disease develops necrobiotic processes in pancreatocytes, caused by autoaggression, contained in them by enzymes( amylase, lipase, protease).
The condition in white color of the prostate is accompanied by a violation of the outflow of enzymes, stagnation of the arterial and venous circulation in the organ, the swelling of the parenchyma( cellular and stromal pathogenesis component).All this leads to an increase in overall dimensions, which, in turn, reduces the density of its tissue.
Thus, the pancreas with low echogenicity - high permeability for ultrasonic waves is visualized on the monitor of the device( there is no sound reflection or it is extremely low intensity).There is no boundary reflection of the impulses from the structure, and the analyzer of the device perceives it as transparent, forming a picture of the pancreas of white color.
Light pancreas
In some situations, there is a diffuse increase in the echogenicity of the tissue, but the size and general shape of the pancreas remains within the boundaries of the reference values.
Such manifestations are most typical for pancreas-lipomatosis - the replacement of pancreatocytes with fat cells( tissue), varying degrees of area. It is most typical for the elderly, as a reflection of the processes of senile involution in organs and tissues, and also occurs in the younger generation due to the increase in body weight associated with obesity.
Fatty tissue is absolutely permeable for ultrasound, but because of the remaining parenchyma sections with functionally active cells( clusters, "micro-islands"), some of the waves are reflected in the receiver of the apparatus.
When summarizing such data, the image ˗ "light pancreas" is displayed. In addition, this color is observed when macroscopic examination of this organ( laparoscopy, intraoperative examination, postmortem autopsy).
Acute pancreas
There is an extensive group of diseases affecting the parenchyma of the body with uneven patches or bands.
The initial pathogenetic factor can be represented by the main two isolated variants with the possibility of their diverse combination:
- vascular - the vascular lesion and as a consequence, the cells and tissues associated with it. Observed with microthrombosis, embolism and atherosclerosis. The glandular cells during the "non-working" portion of the vessel degenerate into adipocytes( fat cells) or degenerate to a connective tissue that has a dense structure;
- protocol - blockage of the duct formed by stones of small size or persistent spasm of smooth muscle cells. There is an accumulation of secretion, which begins to damage and destroy the secreting cells. As a result, the result, as in the vascular mechanism.
With the progression and spread of such processes, the organ partially degenerates into adipose and connective tissues in the form of bands, spots or sinuous lines. The monitor reflects the organ - the mottled pancreas because of the different density( throughput) of the formed tissues. At visual inspection pancreas the description corresponds to the characteristic - "motley".
Black pancreas
With massive pancreatocyte degradation with diffuse formation of connective tissue throughout the entire volume, the structure of the gland acquires a high density. This increases echogenicity with normal or reduced organ size, which is most common in fibrosis.
Its development is the final stage of inflammatory processes of various genesis or systemic metabolic disorders. Fibrotic and cicatricial changes with ultrasound create a picture perceived as a "black pancreas".