Pancreatic inflammation is called pancreatitis. But in order to reliably establish a diagnosis, differential diagnosis must be carried out. Pancreatitis can be acute or chronic. It is important to know its characteristic features in order to distinguish it from other gastrointestinal diseases.
Similar diseases
You can choose the most suitable treatment tactics if you know the diagnosis exactly. For this, a differential
diagnosis of pancreatitis is carried out
. It is important to be able to distinguish this disease from a number of others that are similar in symptoms. These diseases include:
- pancreas cancer;
- peptic ulcer (perforated ulcers);
- cholecystitis;
- intestinal obstruction;
- acute appendicitis;
- myocardial infarction.
It is possible, as a rule, to determine which particular problem causes certain symptoms only in a hospital. Doctors need to know the characteristic signs of all diseases in order to accurately establish the diagnosis.
Differential diagnosis
It is possible to detect a tumor in 85% of cases using computed tomography. But it is best to conduct differential diagnosis of cancer and pancreatitis using ERCP - endoscopic retrograde cholangiopancreatography.
Pancreatitis can be distinguished from a perforated ulcer by the behavior of the patient. In the first case, he will try to take one position and not move. With pancreatitis, patients are restless. In addition to pain, they have vomiting.
To understand what exactly bothers a person, you can use ultrasound. This study makes it possible to diagnose cholecystitis. In this disease, patients complain of pain on the right side, which goes into the corresponding shoulder. An ultrasound with cholecystitis shows an inflammatory process.
Intestinal obstruction manifests itself in the same way as pancreatitis. You can distinguish these diseases by blood tests. For this, pancreatitis is diagnosed. Tests will show diastases and an increased level of chloride with inflammation of the pancreas.
Pancreatitis Classification
To understand how inflammation of the pancreas is manifested, it must be understood that it can be acute or chronic. In the first case, the symptoms are pronounced, it is easy for the doctor to understand that the patient has acute pancreatitis. Diagnosis is mandatory, and only after confirmation of the doctor’s assumptions (with the help of ultrasound and tests) treatment is prescribed.
Chronic pancreatitis is characterized by alternating periods of slight improvement / worsening. In this case, the inflammatory process is sluggish. But it leads to atrophy of the gland tissue.
Characteristic of acute inflammation
Laboratory diagnosis of pancreatitis is necessary to determine the severity of the disease. Acute inflammation can occur in a mild form. In this case, organs and systems are minimally affected. The disease is expressed in edema of the gland. Such pancreatitis is easily treated, patients recover quickly.
With a severe form of acute inflammatory process in the pancreas, pronounced disorders in various organs and tissues are observed. In addition, a severe form may be accompanied by such complications:
- pancreatic abscess (pus accumulates in the pancreas or surrounding tissues);
- acute false cyst - occurs 4 or more weeks after an attack of pancreatitis, characterized by an accumulation of pancreatic juice ;
- pancreatic necrosis (tissue infection is also possible);
- acute accumulation of fluid in the near-pancreatic space or in the gland itself.
This must be considered when diagnosing. Pancreatitis, which started tissue necrosis, can be fatal. This occurs, as a rule, with the development of a purulent form of the disease.
Options for the chronic form of inflammation
Specialists distinguish two subspecies of chronic pancreatitis. It can be primary or secondary. In the first case, inflammation begins directly in the pancreas. Secondary chronic pancreatitis develops against the background of other diseases of the digestive system. It is a complication.
With this disease, inflammation can sometimes decrease, then begin to develop with renewed vigor. But this is not as harmless as it might seem at first glance. A competent diagnosis of chronic pancreatitis is necessary, because with it tissue atrophy can begin, the pancreas calcifies over time, its normal tissues are replaced by scars.
Symptoms of acute pancreatitis
You can figure out when you need to see a doctor if you know the signs of the onset of an active inflammatory process. These include a pronounced pain symptom. Most patients indicate an epigastric region (left hypochondrium). The girdle pain, it can give to the area of the left shoulder blade. In the supine position, it only intensifies. Deterioration is observed after drinking alcohol, fatty, fried or spicy foods.
In addition to pain, there are other signs that indicate that acute pancreatitis has begun. Diagnosis and treatment should be carried out in a hospital hospital. This will allow the most accurate diagnosis and reduce the time required to restore health. Symptoms of this disease are:
- temperature rise;
- vomiting, which does not bring relief (may be indomitable);
- moderate yellowness of the sclera, in some patients the skin may look yellowish;
- hemorrhages in the navel, bluish spots on the body;
- heartburn;
bloating, flatulence.
Also, the disease is evidenced by a violation of the stool, the appearance of excessive fatigue, a decrease in pressure, pallor of the skin and increased sweating. Patients often complain of dry mouth, when examined, a white coating on the tongue is visible.
Signs of chronic inflammation
To understand that you have problems with the pancreas is possible not only through indomitable vomiting and severe pain. Some people may suffer for years and not realize that they have chronic pancreatitis. Diagnosis and treatment will be complete if the patient promptly goes to the hospital.
The development of chronic pancreatitis is indicated by:
- Periodic pains localized in the left hypochondrium, often they give to the back;
- periodic feeling of nausea;
- diarrhea, in which there is a characteristic odor;
- sudden weight loss;
- deterioration of health after eating fatty, fried, smoked foods.
If pancreatitis is not treated, then the patient develops weakness, dizziness. Some may even develop type 2 diabetes, memory impairment becomes noticeable, breathing problems appear.
Laboratory Diagnostic Methods
Upon admission of patients with suspected pancreatitis, they are assigned a comprehensive examination. First of all, a biochemical blood test is done. It allows you to determine the type of disease, thanks to this test, the diagnosis of pancreatitis is more accurately carried out. Analyzes provide an opportunity to clearly present the picture of the disease.
With inflammation of the pancreas, the level of alpha-amylase, lipase increases, the activity of C-reactive protein increases sharply. If the disease is accompanied by a malfunction in the kidneys, then the level of urea in the blood increases. At the same time, you can see a decrease in the amount of proteins, including albumin. The amount of insulin also decreases markedly, which is why glucose levels begin to rise.
Water and electrolytic analysis allows you to determine how much the composition of blood has changed. A decrease in fluid level can cause blood clots and blockage of small vessels. Also, this analysis allows you to determine the concentration of minerals: potassium, sodium, calcium. They are responsible for the normal functioning of the heart and blood vessels.
A general blood test gives an idea of the nature of the disease. Pay attention to the level of leukocytes and red blood cells. Without this examination, a complete diagnosis cannot be carried out.
Pancreatitis is also established by urine analysis. With this disease, the level of alpha-amylase deviates significantly from the norm. But this is observed only in the initial stages of the disease. With the progression of pancreatitis in the urine, red blood cells, white blood cells and other components can be detected.
Instrumental diagnostics
Methods for diagnosing pancreatitis are quite diverse. In addition to the study of biological fluids, the doctor needs to see how the pancreas has changed. It is also necessary to establish whether its inflammation has affected the surrounding organs and tissues.
The most accurate and effective is considered to be ultrasound diagnostics. It allows you to visualize the gland, see if there are inflammatory processes, whether the tissues of this organ have been minced. Diagnosis of chronic pancreatitis can also be done using ultrasound. This disease can be determined even in an asymptomatic period. Also, ultrasound allows you to examine the bile ducts, determine the onset of purulent abscesses and see the fluid.
Laparoscopy can simultaneously diagnose and treat pancreatitis. In some cases, during this mini-operation, it is possible to minimize the negative effect of inflammation on other organs. But laparoscopy is used only in extremely severe cases.
Computed tomography can also be used to diagnose. Pancreatitis can be established by characteristic signs: an increased size of the pancreas, the presence of inflammatory processes and dead tissue.
Endoscopy allows you to see all the changes both in the pancreas and in the duodenum. For this, an endoscope with a camera installed on it is inserted into the esophagus.