Purulent pancreatitis - suppuration of the pancreas, with concomitant abscesses from tiny, almost invisible, to clearly visible and visible to the naked eye on ultrasound. Thus the parenchyma is completely impregnated with pus. This is a malaise with high mortality and is often found in connection with the already existing acute pancreatitis. In addition, this disease can act as a complication, especially after suffering from syphilis, typhoid, mumps.
Infection from the duodenum and bile duct penetrates directly into the pancreas, impregnating its tissues. Lymphatic pathways and organs adjacent to the gland can also be infected by transferring the infection to the organs of the abdominal cavity.
However, one thing should be considered: purulent pancreatitis and gland abscess are not the same, they are completely different diseases. In diagnosing it is important to accurately identify the disease in order to choose the right decision regarding treatment, because the way of treatment here will also differ.
It is caused by diffuse suppuration( phlegmon) of the pancreatic tissue and develops over 2 weeks from the time that the acute form pancreatitis began to develop. Phlegmon is a diffuse purulent inflammation of the cell spaces. If the abscesses have their clear boundaries, then the phlegmon does not have these boundaries. Accordingly, the abscess of the pancreas is a separate concentration of pus. In addition, the abscess is formed over a longer time than such pancreatitis. Its formation can be up to 6 weeks time. The abscess of the gland is less dangerous to life and in the case of surgical intervention it does not have a high mortality rate.
For the treatment of purulent pancreatitis, laparotomy is the optimal solution - abdominal surgery by cutting the abdominal wall. Whereas with abscess of the gland it is possible to achieve inflammation by puncture drainage. This mini operation allows you to get to the educated purulent pathological abscesses and remove them. Such an operation is performed by means of permanent scanning and control by visualization methods, such as fluoroscopy, ultrasound, CT.
The purpose of postoperative treatment is to eliminate infection, intoxication, fight with pain syndrome and dehydration of the body. It is important to restore the normal functionality of the cardiovascular system and regulate the secretory activity of the pancreas.
Symptoms of purulent pancreatitis
At first, the patient has a decrease in appetite. Soon, nausea and eructation appear. Vomiting is a constant process that accompanies the disease. Since purulent pancreatitis disrupts the functioning of the digestive tract, there is an increased secretion of saliva, a person is very thin.
Symptoms of purulent pancreatitis are pain in the abdomen or back. When taking fatty, as well as spicy food, there is a sharp, drilling pain. Another causative agent of pain receptors is alcohol. The place of appearance of unpleasant sensations depends on the sector of inflammation of the gland. The process is accompanied by increased gas formation. Strongly changing the habitual chair. In the stool, you can see the particles of undigested food. Diarrhea is also a symptom.
Acute purulent pancreatitis
This is the most severe form of pancreatitis, which is observed only in 10-15% of patients. A distinctive feature is the extremely high lethality. In most cases, the root cause is a neuro-vascular disorder or food poisoning. Very rarely, the disease is the result of typhoid, syphilis, or mumps.
In the gland, the infection penetrates the duodenum or bile duct. If the neighboring organs are infected with an infection, the inflammatory process can be transmitted to the lymph nodes. Nevertheless, most experts note that acute purulent pancreatitis is a consequence of a combination of several pathogenic factors. A special role is played not only by the penetration of the infection, but by the presence of an appropriate environment. The acute form of the disease for successful development requires damaged vessels, ducts and glandular tissue. Once the release of trypsin and lipase is activated, circulatory disorders start. Among other factors that cause this disease, identify the wrong food, pancreatic injury, stomach disease.
Fatal outcome
The most negative development of events is possible in 10-15% of cases. Several departments of retroperitoneal tissue are affected. The disease also attacks the surface of the large omentum, the ligamentous ligament, the visceral and parietal peritoneum. First, the lesions are focal. Lethal outcome in purulent pancreatitis in most cases is associated with inopportune diagnosis. As a result, pathogenetic therapy is applied too late.