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| Describing
the history
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Describing the history, symptoms, and physical examination
findings of a patient with pancreatitis
As a rule the patient with pacreatitis in anamnesis has the
diseases of gastrointestinal tract, such as chronic gastritis,
cholecystitis, enteritis, cholelithiasis. By the way the development
of the disease is also promoted by alimentary factors: irregular
food, frequent use of fatty fried food with various spices,
together with systematic deficit proteins and vitamins in
food and abuse of alcohol. So, the delay of secretion and
intraorganic activation of pancreatic enzymes - tripsin and
lipase, accomplishing the autolysis of gland’s parenchyma
results in reactive overgrowth, shrinkage and general sclerosis.
The symptoms are the pains in epigastria and left hypochondrium,
depending on the location of affection. Pain irradiates to
the back and has the belting character. Plus to that there
is the pain in Mayo-Robson’s point and area of hyperesthesia
in the zone of Th8 innervation. Often there is an increased
salivation, belch, attacks of nausea, vomiting, flatulence,
diarrhea.
In the blood there is moderate hypochromic anemia, the increase
of ESR, neutrophilic leukocytosis, hypoproteinemia and disproteinemia
due to the high content of globulin. With the development
of diabetes new signs add: hyperglycemia glycosuria and even
violation of electrolyte metabolism, in particular hyponatremia.
The contents of tripsin, antitrypsin, amylase and lipase in
the blood and amylase in the urine increase. In duodenal contents
the concentration of enzymes and general amount of digestive
juices frequently decrease, promoting pancreatic hyposecretion.
Duodenography, ultrasonic scanning, computer tomography scanning
identify the deformation of duodenum, the increase of pancreas
sizes, its shadows, echostructure and echogenicity.
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