Complications of pancreatitis: features of the course and tactics of treatment

Abstract

The aim of this article is to draw attention of gastroenterologists, surgeons and primary care physicians to the features of the course of pancreatitis complications, which tend to have an acute course and are a complex process that causes medical errors and life tragedies.
 The importance of complications of pancreatitis such as cysts, pseudocysts, fistulas, cholestatic syndrome, portal hypertension syndrome, bleeding from varicose veins of the esophagus, stomach and erosive-ulcerative secondary gastroduodenal processes is emphasized.
 Attention is focused on the mechanisms of development of these complications, features of the clinical course, management tactics of such patients, depending on the location of the complications, which is important for the treatment strategy (conservative or surgical). The peculiarities of the clinical picture of the syndrome of compression of neighboring organs, thrombosis of the hepatic and splenic veins, biliodigestive bleeding, including hemobilia, bleeding from the large and small duodenal papilla, are directly related to the analytical approach regarding the diagnosis of these complications. Angiographic techniques are considered to be the most effective diagnostic techniques, which include celiacography, upper mesentericography, percutaneous and transhepatic portography. It is indicated that on their basis, techniques for stopping bleeding have been developed, namely endovascular catheter hemostasis.

Chronic pancreatitis: about some complications and features of their pathogenesis and course

“…За наявності уражень ПЗ у периферичній крові формується гіперферментемія (значимо підвищуються показники амілази та трипсину), причому амілазурія високого ступеня за даними сечі виявляється на початку процесу (при довготривалому перебігу показники діастази значимо знижуються, частіше за все в зв'язку з фіброзом ацинарної тканини). Але таке може засвідчувати і некротичний характер ураження залози і вважається негативною прогностичною ознакою при рецидивуючому перебігу ХП [4,5].…”