Pancreatitis is a serious pancreatic pathology that is rapidly developing and in the absence of timely treatment leads to dangerous consequences. In ICD-10 in acute destructive pancreatitis, the code is K85. With this disease, metabolic processes in the body are disturbed, and the pancreas begins to digest itself. As a result of this process, organ cell necrosis occurs. The article will take a closer look at the symptoms and causes of this dangerous disease.
What it is
By destructive pancreatitis is understood inflammation of the pancreas, its tissues die and are no longer restored. The organ swells and literally begins to devour itself. Pathology develops as a result of metabolic disorders. This leads to malfunctioning of other body systems, primarily the gastrointestinal tract.
Acute destructive pancreatitis begins with ordinary pancreatitis. This is always signaled by specific signs. The presence of pathology greatly affects the functioning of the human nervous system, up to the onset of coma. Without treatment, the disease progresses rapidly and at some point can lead to irreversible consequences. Statistics say 25% of patients with pancreatic necrosis (acute destructive pancreatitis) die.
Stages
Specialists distinguish several stages of pancreatitis:
- Enzymatic: within three days, necrotic changes develop in the tissues of the gland. Pancreatic enzymes come out of the cells, and under the influence of phospholipase A, cell membranes are destroyed.
- Reactive: lasts from the second to the third week from the onset of the disease. The further course of the disease depends on the reaction of the body to tissue death. The outcome will depend on whether resorption of the infiltrate occurs or cysts and abscesses form.
- Sequestration. According to ICD-10, destructive pancreatitis has a code of K85. This stage begins with the third week from the moment of development of the pathology and lasts several months. During this period, fistulas and cysts form, internal bleeding, blood poisoning can begin. This is the most dangerous period of the disease during which a fatal outcome is possible.
Forms of acute destructive pancreatitis
The disease has three forms, which depend on the intensity of the manifestation of symptoms and the degree of development:
- Toxemia: toxic substances that have a bacterial environment enter the bloodstream. This form is characterized by nausea, vomiting, and diarrhea.
- Abscess. It occurs with accumulation in the tissues and organs of pus. An abscess can form both in the pancreas itself and in neighboring organs.
- The next form of destructive pancreatitis is purulent changes both in the organ itself and in the retroperitoneal space.
Causes
Several factors are known that lead to the development of such a deadly disease as pancreatic necrosis. The main ones are: alcohol abuse and gallbladder disease.
- Excessive consumption of alcoholic beverages is considered the most common cause of the development of pathology. As a rule, the disease appears in people who abuse alcohol from five to fifteen years. However, cases of the occurrence of pancreatitis with a single intake of alcohol, often in combination with fatty or fried foods, have been recorded.
- Cholelithiasis. Pathology develops due to obstruction of the sphincter of Oddi with a stone, in connection with which bile begins to enter the pancreas. Another reason may be a blockage of pancreatic ducts with stone, which leads to activation of enzymes in the gland itself.
Other reasons
In addition to the main factors influencing the development of the disease, there are several more reasons:
- Viral and infectious diseases.
- Congenital pathology of the pancreas.
- Injuries to this organ.
- The presence of parasites in the body.
- Prim a large number of drugs.
- The consequences of surgery.
- Bites of poisonous insects.
- Poisoning by toxic agents.
Symptoms
There are three main symptoms that indicate malaise and development of pancreatitis:
- bloating and flatulence;
- severe pain syndrome;
- nausea and vomiting.
Pain is felt on the left side of the body and back, can be given in the side or in the region of the heart. The pain has a girdling and aching character, and can subside when a person is in a prone position, with legs raised to the chest. As soon as the patient gets up, discomfort returns. The intensity of the pain syndrome is individual: for some, the pain seems bearable, while someone is exhausted from it.
Frequent vomiting leads to dehydration, while redness of the face, pallor and loss of consciousness can be observed.
Also, with destructive pancreatitis, there are: increased body temperature, increased heart rate and shortness of breath. Blue spots may appear above the navel, on the buttocks and sides, yellowing of the eyeballs and panic mood.
Diagnostics
Diagnosis of destructive pancreatitis is complicated by the fact that the symptoms of the disease are similar to the symptoms of other diseases. As a result, a thorough examination is required. If there is a suspicion of an acute form of pathology, the patient is taken to a hospital and, in addition to diagnosis, emergency care is provided.
Specialists identify the stage of pancreatitis, the degree of damage to the body and establish the root cause. To do this, conduct such studies:
- blood and urine tests are given;
- using ultrasound reveals the size of the pancreas, its shape and the presence of fluid in the retroperitoneal space;
- the degree of bloating of the intestine is detected using x-ray studies;
- to establish the presence of blood in the cavities and hemorrhages on the side of the abdomen, laparoscopy is performed;
- using computed tomography and MRI, sections of necrosis are detected, and the state of other organs is monitored.
Treatment
Most often, the patient goes to the hospital at the stage of toxemia. After the studies, the specialist makes an individual treatment for destructive pancreatitis. Most often, the disease has an unpredictable course, so the doctor should be prepared for different options for the development of pathology.
In a hospital, the following types of treatment are carried out:
- pain relief;
- elimination of spasms and inflammation of the pancreatic ducts;
- prevention of inflammatory processes;
- removal of intoxication;
- therapy aimed at improving heart function.
In the absence of the necessary effect of drug treatment, surgery may be indicated.
Operation
Surgical intervention for destructive pancreatitis helps to restore the outflow of pancreatic enzymes and eliminate the necrotic area of the gland. The most successful is puncture-draining treatment.
The operation is also prescribed when the presence of stones, abscesses or cysts is detected.
The patient is provided with drainage and the dead areas are removed. Resection is less required. The method of performing the operation can be puncture or laparotomic (with an opening of the abdominal cavity) and laparoscopic, using a puncture. Such operations are carried out no earlier than five days from the onset of the development of the disease.
Diet
When diagnosing pancreatitis in the first day, a complete refusal of food is prescribed, while the patient should consume a large amount of water. It should be non-carbonated and clean, gradually water can be replaced with a decoction of wild rose or fruit drinks.
After 3-5 days, the menu can include soups and cereals on the water, and subsequently expand the menu. Diet suggests the following rules:
- refusal of prohibited foods: fatty, fried, egg yolks, salted, smoked, carbonated drinks, mushrooms, baked and sweet, coffee, chocolate.
- food should be fractional - four to six times a day, every three hours;
- dishes should be cooked using stewing, baking and boiling.
The dietary menu for destructive pancreatitis allows you to use:
- all kinds of dishes from boiled vegetables;
- berries and fruits;
- mashed potatoes;
- cereal dishes;
- vegetarian soups;
- low fat fermented milk products;
- low-fat fish;
- jelly, sweet juice, tea.
Complications
Untimely treatment of the disease can lead to such dire consequences:
- the disease can develop into a chronic form with enzymatic deficiency ;
- decrease in the amount of blood;
- shock;
- inflammation of the peritoneum;
- internal bleeding;
- purulent formations;
- anemia;
- blood infection;
- the appearance of ulcers;
- blockage of venous vessels by a thrombus;
- proliferation of connective tissue - fibrosis.
Most often there are purulent inflammations, they appear together with the death of tissues or after 1-2 weeks.
The most common purulent complications. They can develop in parallel with tissue necrosis or after 1-2 weeks.
Forecast
Acute destructive pancreatitis is a dangerous pancreatic disease, which leads to serious consequences in the absence of timely treatment. In advanced cases, without therapy, the pathology is fatal.
An abnormal lifestyle leads to the development of pancreatic disease:
- snacks on the run;
- unhealthy food;
- smoking;
- alcoholic beverages;
- ignoring infectious diseases in the body.
The following factors also affect the outcome of the pathology:
- the degree of effect of enzymes on tissues;
- the presence of local and systemic complications;
- patient age;
- the presence of concomitant diseases;
- the size of the focus of necrosis;
- timeliness of the operation.
The most sad prognosis is observed with such symptoms:
- old age, over 50 years old;
- high levels of white blood cells in the blood;
- diabetes;
- high concentration of urea;
- high activity of liver enzymes;
- dehydration.
In severe cases, the probability of death rises to 50%. Early treatment can reduce risks and improve prognosis.
With timely access to a specialist, pancreatitis lends itself to successful treatment. To do this, you need to visit a gastroenterologist every six months, who will be able to timely detect the presence of any disorders in the body and prescribe the necessary treatment.