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Describing the history

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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