Diagnosis of chronic pancreatitis, differential diagnosis, criteria, rationale and formulation, how to determine?

Chronic pancreatitis is a difficult-to-diagnose disease that, during an exacerbation period, in order to obtain an accurate diagnosis and cut off other digestive system diseases that have similar symptoms, it is necessary to perform differential diagnosis.

First of all, chronic pancreatitis should be differentiated from such diseases as:

  • intestinal tuberculosis;
  • abdominal ischemic syndrome;
  • Solaris;
  • stomach ulcer;
  • pancreatic tumor;
  • duodenal ulcer;
  • chronic colitis;
  • cholelithiasis.

Having carried out a differential diagnosis of the patient and based on the results obtained for the uncharacteristic symptoms for these diseases, they sweep aside all the diseases that a particular patient can not have. When, using differential diagnosis, it is accurately established that a patient can have only one diagnosis - chronic pancreatitis, they begin to study the complications of the disease. For this, the following diagnostic methods are allowed:

  • An elastase test is performed, trying to determine the extent of the inflammatory processes in the gland. To do this, assess the presence and amount of interleukins, tumor necrosis factor, platelet activating factor, and also the level of lipase and amylase.
  • In order to determine the state of exocrine gland failure, the indicators of such laboratory diagnostic methods as Lund test, coprologic test, renimampin test, secretin-pancreosimine test are evaluated. It is equally important for the correct diagnosis of chronic pancreatitis to assess the clinical data, determining the volume of the patient's stool, examining it for the absence or presence of creators and streatera.
  • It is very important for the completeness of the diagnosis of chronic pancreatitis to establish the extent of organic lesions of organs closest to the pancreas and the gland itself. For this purpose, instrumental examination of the patient is carried out using methods such as intravenous cholangiography, radionucleic cholecystography, endoscopic pancreatocholangiography, esophagogastroduodenoscopy, computed tomography, ultrasound and radiographic survey.
  • Diagnosis of the pancreas is performed to determine the exacerbation of chronic pancreatitis in the patient, as well as tumors with laparoscopic biopsy and tumor marker studies.

Only after carrying out all differential analyzes and diagnosing the degree of severity of exacerbation of chronic pancreatitis, it is possible to prescribe the most optimal method of treatment.

How to identify chronic pancreatitis?

As a rule, such a medical diagnosis can be made by a competent specialist after carrying out a series of diagnostics. First of all, the doctor appoints an ultrasound examination of the abdominal cavity. Short, it is called ultrasound. This procedure allows you to identify the signs of an ailment, for example, such criteria as the tightening of the tissues of the diseased organ.

But, after only one such study, the doctor, with complete certainty, can not establish the diagnosis. Therefore, without fail, it is necessary to pass the analysis of feces and blood to enzymes, glucose. Their composition directly indicates the existing problems.

In addition, the specialist conducts a detailed consultation with the patient. During which, he learns about complaints, general health, the existing malaise and other factors of health. And after the described procedures, the doctor can declare about the presence of chronic pancreatitis.

But, sometimes there are also disputable cases when a specialist has a number of doubts. In this case, additional studies are assigned. For example, such as: biopsy, computed tomography and many others.

Justification and wording of the diagnosis of "chronic pancreatitis"

The following are the reasons for the formulation of this diagnosis:

  • The supporting signs revealed during the research: uncontrollable stool, vomiting, bitterness in the mouth, surrounding pain in the left hypochondrium;
  • The results of laboratory diagnosis of chronic pancreatitis: increased ESR, presence of bilirubin, the determination of a number of specific enzymes, a decrease in glucose tolerance;
  • Indicators of laboratory studies: increase or decrease in the size of the pancreas.

The wording of the diagnosis of an ailment must necessarily contain such aspects: origin, stage, anatomical organ changes, the course of the disease, complication. For example, it might look like this: "Chronic pancreatitis, recurrent flow, exacerbation phase".

Have diagnosed "chronic pancreatitis," what to do?

First of all, you should seek competent medical help. The specialist will prescribe a number of medical procedures, prescribe some medications. Informs about the need to comply with the type and type of diet, as well as details about the necessary treatment regimen. Unfortunately, it is impossible to cure the disease completely. But, taking medications, following the diet and prescribing the doctor, the state of health can be significantly improved.

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