Echogenicity of a healthy pancreas parenchyma on ultrasound is similar to echogenicity of the liver and spleen. In its structure, iron has a head, body and tail of optimal size. Unfortunately, specialists who already have problems turn to specialists, and on the monitors of diagnostic devices they often see signs of diffuse changes in the pancreas due to its inflammation or other pathology.
About diffusion
The term "diffusion" in Latin means "spreading" or "interaction". From the point of view of physics and chemistry, this is the penetration and interaction of atoms or molecules of one substance with atoms and molecules of another. Studying the phenomenon of diffusion, scientists better began to understand the essence of the processes taking place in the human body. This is most often the pancreas. Diffuse changes - what is it?
This phenomenon can be observed easily. Just add a little ink to a glass of water and see how the substances mix. In anatomy, this phenomenon is associated with the interaction and replacement of one cell by another. This is exactly what is detected by ultrasound: cells altered by pathology are located next to healthy ones. Signs of diffuse changes in the pancreas, as a rule, are local (focal) or mixed (diffuse) in nature.
What are the diffuse changes in the pancreatic parenchyma?
Pathogenic changes in glandular tissue are most often chronic, and therefore there are no symptoms. But on ultrasound with normal sizes in the gland, echogenicity is increased. In elderly patients suffering from cardiovascular diseases, diabetes mellitus, healthy cells gradually die out, they are replaced by connective or adipose tissue.
Also, such transformations are observed in violation of the blood supply to the enzyme-forming organ, liver, in violation of the functioning of the biliary tract, in violation of the endocrine and metabolic processes. In what other cases do diffuse changes in the liver and pancreas occur?
Similar symptoms are observed with pancreatitis or dystrophic disturbance of the metabolic process. The diagnosis of pancreatitis may not be confirmed, and then treatment is not prescribed, and the patient does not recognize DIP. Typically, spreading changes occur in the glandular tissue. In the chronic course of diseases, pathogenic tissue changes are almost asymptomatic. These are moderate diffuse changes in the pancreas.
Provocative factors
The disease can be triggered by various reasons:
1) Imbalance in nutrition. Abuse of fatty, floury, salty, sweet and spicy foods.
2) Genetic predisposition.
3) Stress and nervous strain.
4) Drug and alcohol addiction.
5) Chronic diseases of the digestive system.
6) Self-medication and unsystematic use of drugs.
How to treat diffuse pancreatic changes? Consider this below.
Insufficient amounts of insulin in the blood and the detection of glucose in the urine are also provoked by DIP. As a rule, the cause of these changes is pancreatitis, which must be treated. It is also necessary to observe certain rules of behavior of the patient, diet.
The main signs of diffuse changes in the pancreas
Typically, signs of CI are associated with the underlying disease. Most often, patients complain that they feel heaviness in the stomach, they suffer from frequent diarrhea or, on the contrary, constipation. In acute pancreatitis, the pressure in the pancreatic duct often increases, which can cause its deformation. Due to impaired enzymatic function, part of the digestive enzymes can pass through the cells of the pancreatic parenchyma and cause poisoning of the body. In this case, the patient experiences pain on the left under the sternum, nausea, often accompanied by vomiting. An increased pulse and low blood pressure are observed. This condition, as a rule, requires hospitalization.
The initial stage of chronic pancreatitis is discouraged by the appearance of edema and hemorrhage in the tissues of the gland. Then atrophy occurs, the gland decreases in size, the growth of connective tissue occurs, and enzyme-forming cells cease to produce digestive enzymes. Fibrosis is also accompanied by the displacement of healthy pancreatic cells and the replacement of their connective tissue. The production of hormones and enzymes ceases. At the initial stage, the symptoms are scanty and often similar to signs of inflammation of the pancreas. Moderate diffuse changes in the pancreas appear.
About lipomatosis
Replacing normal organ cells with adipose tissue is called lipomatosis. The symptomatology of DIP with lipomatosis depends on its volume. With minor changes in DI, the pathology may not declare itself, but in more serious cases, the body gradually begins to experience a deficiency of hormones and enzymes. The proliferation of lipoid tissue leads to compression of the parenchyma and, as a result, impaired pancreatic functioning and the appearance of pain. These are diffuse changes in the pancreas by the type of lipomatosis.
Hollow organs include the stomach, urinary and gall bladders. Organs consisting of parenchyma (glandular tissue): pancreas, spleen, liver, etc. The main function of the pancreatic parenchyma is the production of enzymes and hormones.
In diabetes, chronic pancreatitis, or acute pancreatitis, changes often occur.
Ultrasound shows an increase in echogenicity of glandular tissue, this is due to the inflammatory process and when the connective tissue (fibrosis) coarsens, which leads to an increase in density. The cause of this anomaly is an imbalance in metabolism. Another reason for the increase in echogenicity is lymphomatosis (replacement of the parenchyma with fat cells).
Swelling of the gland can occur due to pancreatitis, due to which the density of the parenchyma changes and, as a result, the echogenic reaction also changes.
How are diffuse changes in the parenchyma of the liver and pancreas reflected in the state of the organs?
Structure changes
The structure of the parenchyma can be homogeneous and fine-grained. Slightly increased graininess is also not a large deviation. In aggregate, an increase in granularity indicates inflammation and dystrophic changes in the gland associated with malnutrition.
A healthy pancreatic parenchyma resembles the echostructure of the liver, which is equally homogeneous and fine-grained. Age-related changes in echogenicity of the structure of the gland indicate developing lipomatosis, which is often associated with the onset of diabetes. Signs of diffuse pancreatic changes can be very informative.
Reactive DIP
This is her secondary changes, a response to pathology in neighboring digestive organs, closely related to her. Especially often, DI glands arise due to problems with the liver and biliary tract, as it interacts most closely with these organs. In an ultrasound, the reactive echoes of diffuse changes in the pancreas resemble acute pancreatitis, as they are most often its secondary consequence.
Fibrous DIPJ
Fibrous DI is scarring in the gland of connective tissue that spreads through the cells of the tissue. The reasons for this process are often:
1) metabolic disorder.
2) Alcohol poisoning.
3) Viral lesions.
4) Inflammatory processes.
Moreover, lesions caused by viruses affect the entire hepatobiliary system, and not just one pancreas. On ultrasound, diffuse changes in the pancreas have high echogenicity and density. The presence of diffuse fibrotic changes may indicate an existing benign tumor of the glandular tissue - fibroma, the growth of which can compress the gland and cause pain.
Different symptoms will be present depending on the location of the fibroid. For example, when it is located in the head of the pancreas, the duct is pinched, and a symptom of jaundice occurs. If the tumor presses on the duodenum, nausea, vomiting, and other symptoms occur that require differentiation with intestinal obstruction. What else are the echoes of diffuse pancreatic changes?
Dystrophic DIPJ
Healthy glandular cells are replaced by fatty tissues that are unable to perform the enzymatic function of the pancreas, which leads to hypofunction of the gland. For lipodystrophy, which occupies less than half the volume of the entire gland, a mixed drug treatment is used in conjunction with a diet. If the lesion covers more than half of the organ and its work is impaired, surgical intervention is indicated. Diffuse changes in the liver and pancreas parenchyma in some cases are life-threatening.
In the structure of this secretory organ, three elements are distinguished: the body, head and tail, which has a pear-shaped shape and adjacent to the spleen. Normally, its width is 2-3 cm. The excretory duct about 15 cm long passes through the entire gland. Clogging of the hepatic vein can lead to pancreatic tail DI, the symptoms of this are that this part is compacted.
About a quarter of all pancreatic diseases are associated with diffuse tail changes. In case of minor lesions of the tail, they are treated with conservative methods. In the case of deep lesions, the removal of the tail is shown, followed by the closure of blood vessels.
How are diffuse changes in the liver and pancreas detected?
Diagnostics
DIP are determined by ultrasound. Ultrasound reveals that the density and structure of the tissue changes, the foci of inflammation are determined.
But this is not enough to make a diagnosis. To confirm the DI, a biochemical blood test, endoscopy of the gland are performed. It is very important to correctly collect the patient’s medical history (a survey about complaints), as well as conduct additional instrumental studies and palpation.
The general picture is supplemented by a general analysis of blood, urine, endoscopy of the digestive tract, coprogram, etc. Pancreatic enzymes and blood glucose, as well as an inhibitor with respect to trypsin, play an important role.
With the help of ultrasound, the size of the gland and its ducts is determined, neoplasms and seals are detected. To clarify the diagnosis shown: computed tomography and ERCP, allowing more accurately identify the causes of changes in the tissues of the enzyme-forming organ. The most clearly manifested diffuse changes in the pancreas by the type of lipomatosis.
Prevention
The development of DI in the pancreas, liver and other organs can be slowed down. Here are some rules:
1) It is necessary to completely abandon alcohol.
2) Follow a diet, take food in small portions, but often.
3) Minimize the use of fatty foods.
4) Refuse canned foods.
5) Eat freshly squeezed juices and drink herbal teas.
You should not give up if you have been diagnosed with DIP. It’s just worth going through the necessary research and then carefully listening to your body, monitoring the health of such important organs as the liver and pancreas. Diffuse changes, what are these and what are the treatment methods, we examined in the article.