Update: November 2018
Pancreas is such a part of the digestive
system that carries a double load.
- On the one hand, producing enzymes that break down carbohydrates,
proteins and fats (trypsin, chymotrypsin, amylase, lipase, lactase,
maltase, elastase, diastase), iron regulates processes
- On the other, synthesizing beta cells of the islets of Langerhans
insulin and glucagon, this organ ensures the constancy of the internal
environment of the body, regulating carbohydrate, protein and fat
Accordingly, pathological changes of the pancreas
affect many functions of the body. Signs of disease
the pancreas in women are the same as the symptoms of the disease
pancreas in men.
Most often the pancreas suffers from inflammation and
destructive processes. Therefore, the typical manifestations of pathologies
pancreas are symptoms of acute pancreatitis.
Acute pancreatitis is a non-infectious inflammation of gland tissue with
elements of edema, decay and death of glandular tissue (against the background
self-digesting lipase and trypsin), education
connective tissue scarring and impaired normal anatomical
the structure and functioning of the gland. In some cases, the primary
bacterial suppuration may be associated with inflammation,
cyst formation, bleeding, inflammation of the peritoneum.
Starting factors for acute pancreatitis – difficulty in outflow
secretion of the pancreas in the background of the narrowing of its duct tumor
or scar, pathologies of biliary ducts and duodenum,
pancreatic injuries and alcohol intake.
An interesting fact is that there is no direct relationship between
duration of alcohol abuse. Often patients with chronic
alcoholism do without inflammations of the gland for many years, and
non-drinkers may die from the destruction of the body against the background of a single
episode of taking a small dose of alcohol.
There are several diseases of the pancreas, symptoms
which are very similar. Only a doctor can differentiate them.
through laboratory data, instrumental
Symptoms of acute pancreatitis – the most frequent disease
The leading manifestation of pancreatitis is pain. The nature of the pain (from
blunt pulling up to sharp cutting) due to the volume of the lesion, its
nature (swelling or necrosis), as well as involvement in the process of leaflets
peritoneum (peritonitis). In the latter case, symptoms will appear.
irritation of the peritoneum, pain will be more intense during palpation of the gland
not by pressing, but by releasing the hand.
When edema pain due to stretching of the capsule gland,
compression of nerve endings and overflow of ducts with products
For a long time there is a discrepancy between very intense
pain and lack of protective tension of the muscles of the anterior abdominal
walls (the stomach remains soft when probing).
The location of the pain (in the right, middle or left part of the epigastrium)
due to the location of the main pathological focus in
head, body or tail of an organ.
Her back irradiation – the position of the organ in the retroperitoneal
space from 12 chest to 4 lumbar vertebrae and
features of the gland innervation (branches of the celiac plexus and
Read also on the topic:
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- Causes of pancreatitis
- What can you eat with pancreatitis
- Pancreatitis: symptoms, treatment
- Causes of yellow bloom in the tongue
- Causes of vomiting and diarrhea in a child without fever
- Symptoms of jaundice, diseases accompanied by jaundice
- A new type of pancreatic diabetes does not recognize
The pain is usually not associated with food intake and wears
long standing, increasing with increasing
pathological changes of the body. Rarer location of pain –
retrosternal space or region of the heart with irradiation in
collarbone With this pain syndrome, it is important to promptly separate
heart pain (angina pectoris, myocardial infarction).
With pancreatic necrosis, the pain reaches the highest degree and can
lead to a painful shock from which the patient may die.
Dyspepsia accompanying pancreatitis is nausea, disturbance
appetite, vomiting of food eaten and stool instability. how
usually dyspepsia appears at the onset of the disease after
errors in the diet (eating fatty, smoked food, mushrooms,
tomatoes, honey or alcohol). Classics of the genre – vodka, bitten
cold patty and tomato. There are situations when and reception
medicines becomes the trigger for
pathological process (nitrofurans, antibiotics, sulfonamides,
valproic acid, azathioprine, sulfasalazite, cytostatics).
Read more about the treatment, symptoms and causes of dyspepsia.
- Nausea and vomiting
Nausea precedes vomiting and is associated with over-irritation.
vagus nerve innervating the pancreas. Vomiting
develops in more than eighty percent of cases and not
It is caused by intoxication. At first, she usually wears
gastric nature (vomiting of food eaten), and then in vomiting
the masses appear the contents of the duodenum (vomiting
The volume and frequency of vomiting can be very significant, which
leads to gradual dehydration with loss of water and
electrolytes. While predominantly lost salt and develops
There are several degrees of dehydration. Each one has
its clinical picture.
When the first degree is lost up to three percent of body weight,
patients worried about weak thirst, mucous wet. For loss
electrolytes severe thirst is not characteristic, it is replaced by a rapid
breathing (shortness of breath, causes).
In the second degree, up to nine percent of weight is lost. Appears
severe thirst and dry mucous membranes. Reduced skin elasticity
(the speed of unfolding of the skin fold taken in a pinch falls).
The circulatory system also suffers – there is an increase in the pulse and
heartbeats. The number of urinations decreases and the volume decreases
detachable urine, it becomes darker.
The third degree of dehydration is pronounced electrolyte.
violations and loss of up to ten percent of weight. Suffers a common
condition: patients are slowed down, drowsy. They have lowered
blood pressure, there may be cardiac disorders
rhythm, dry mucous and skin, depleted facial expressions, can be confused
speech and consciousness. Acidosis develops in the blood and may develop.
hypovolemic shock with loss of consciousness and multiorgan
- Stool instability
It is manifested by a change in constipation diarrhea. At the beginning of the disease in
patients expressed bloating (flatulence, causes) and delay
stools (see all laxatives for constipation). It’s connected with
the fact that pancreatic enzymes and bile acids possess
laxative effect, do not fall in the proper amount in the intestine.
After several days of constipation, loose stools may appear.
Skin manifestations of pancreatitis are reduced to pallor or
jaundice due to compression of the bile ducts of the edematous pancreas
gland. There may also be some blueness of the fingers, nasolabial
triangle due to intoxication and respiratory disorders (symptom
Lagerlef). Similar bluish spots may appear on the skin.
belly (usually to the right of the navel). This is a symptom of Halstead. Blue
side of the abdomen – a consequence of circulatory disorders in
abdominal cavity (Gray-Turner symptom). Bluish yellow color
the navel is known as Kyulen’s symptom. The bruises surrounding the navel –
Special symptoms available on palpation of the abdomen,
are determined, as a rule, only by a doctor.
- Mayo-Robson symptom – painful palpation of the left
- Dudkevich’s symptom is defined as palpation pain,
when the doctor’s hand is set 2 cm below the navel and moves in
direction inward and obliquely upwards.
- If the edge of the arm to perform jerky movements in the epiphysis,
then the emerging pain indicates a positive symptom
- The symptom of Shchetkin-Blumberg – increased pain during
pulling out his hand while palpating the abdomen, he is most
characteristic of peritonitis. When appearing in the abdominal cavity
pathological effusion associated with the collapse of the pancreas
and irritation of the peritoneum by enzymes, symptoms of irritation are identified
peritoneum, indicating the beginning of peritonitis.
Most characteristic of inflammation or destruction
pancreas will be changes in clinical and biochemical
blood tests, as well as urine changes.
- Clinical blood test
It will respond by increasing the erythrocyte sedimentation rate (more
10 mm per hour for men and more than 20 for women), relative
leukocytosis (an increase in the number of leukocytes above 9 g / l), which
evidence of inflammation. With severe destruction and
joining a purulent infection will appear and the “leukocyte shift
formulas to the left ”, that is, an increase in the number of segmented and
If you determine the hematocrit (the ratio of the number of red blood cells to
plasma volume), it increases due to dehydration (in men
>54, у женщин>47%). Also determined by the relative
increase in red blood cells. In cases where there is
hemorrhagic pancreatitis in the late stages, may develop
anemia (fall in the level of red blood cells and hemoglobin). Glucose level
blood usually increases and exceeds 5.5 mmol / l.
- Blood biochemistry
It is most often determined by the level of amylase, rising
above 125 U / l in the first 12 hours of the disease. If necrosis occurs
gland, amylase falls. Increasing lipase, trypsin and level
enzyme inhibitors – more indicative figures. For today
The most specific increase is considered to be in the first two days.
However, this enzyme is not determined in all laboratories. Grow up
ALAT, ASAT and LDH, indicating cell disruption. By
jaundice increases the amount of indirect and total bilirubin. Acidosis
leads to a drop in calcium levels magnesium and chlorides.
- Urine changes
relate to increasing its relative density, the appearance of protein
(cylinders), leukocytes and erythrocytes during dehydration or
toxic kidney damage. Urine diastase begins to exceed 100
Units at the upper limit of normal in 64 Units. Sugar also appears in the urine.
and ketone bodies, which indicates violations of carbohydrate and
Symptoms of other diseases of the pancreas
In addition to acute pancreatitis, there are a number of other pathologies,
which affects the pancreas. Symptoms of the disease,
diagnosis and treatment often depend on the stage of the process and its
howие симптомы заболевания поджелудочной железы характерны для
most pathologies? This pain, dyspepsia and features
|Chronic pancreatitis||Outside the exacerbation of the process of pain does not bother. During
exacerbations a dull or sharp epigastric pain occurs with
irradiation of the lower back or surrounding pain of varying degrees
|Pancreas cancer||Depending on the location of the tumor and the stage of the cancer, the pain may
to be aching episodic or constant similar to pain when
|Type 1 diabetes||No pain|
|Cystic fibrosis||Cramping pains along intestines|
|Pancreatonecrosis||The most pronounced sharp acute pains in the upper abdomen or behind
грудиной, отдающие в спину или collarbone At the peak of pain can
develop a state of shock with loss of consciousness.
|Pancreatic cyst||Pain dull, intermittent, mild or not at all expressed in
small sized cysts. Bright pain syndrome occurs when
significant size of education due to the compression of the ducts, nerve
trunks or gland capsule tension. When the process in the head hurts
the right side of the upper abdomen, with tail lesions – the left. If a
cyst in the body, pain is localized in the middle of the epigastrium.
|Chronic pancreatitis||Stool instability (смена запоров и поносов). With
errors in the diet (taking fat, smoked, fried, honey,
mushroom, tomato, zucchini) – frequent fatty stools, nausea, can
episodes of vomiting of food or bile.
|Pancreas cancer||In the early stages episodes of nausea and unstable fatty stools
with errors in the diet (more often with cancer of the head of the gland), reducing
appetite. Characteristic abdominal distention, significant weight loss. On
late stages – profuse diarrhea, frequent vomiting.
|Type 1 diabetes||For hypoglycemic conditions characterized by a sharp feeling
hunger and weakness. With кетоацидозе – тошнота, рвота. In patients with
diabetes is greatly reduced weight.
|Cystic fibrosis||Very frequent liquid fatty stools, which volume exceeds the norm.
several times. Decreased appetite, flatulence.
|Pancreatonecrosis||Abdominal distention, stool retention.|
|Pancreatic cyst||Abdominal distension, weight loss, increased stools – with a head cyst
glands. With поражениях тела и хвоста – обесцвеченный стул, запоры,
episodes of nausea.
|Chronic pancreatitis||Aggravation in response to the use of alcohol, fatty, fried,
smoked food, marinades, sweets.
|Pancreas cancer||Jaundice or severe pallor, cancer cachexia in late
|Type 1 diabetes||Thirst, an increase in the volume of discharge of urine, itching of the skin and mucous membranes.
Tendency to hypoglycemia (acute hunger, sweating, palpitations,
fainting), ketoacidosis (weakness, nausea, vomiting, the smell of acetone from
mouth, loss of consciousness, coma).
|Cystic fibrosis||The deposition of salt crystals on the skin, dry mouth, muscle
|Pancreatonecrosis||Clinic of acute abdomen, pain or toxic shock.|
|Pancreatic cyst||Large cysts are felt through the anterior abdominal wall. With
suppuration of the cyst is marked abdominal pain and temperature rise.
Laboratory data and instrumental diagnostics
|Chronic pancreatitis|| Blood elastase 1 rises during exacerbation.
Laboratory signs обострения аналогичны острому панкреатиту.
Stool elastase reduced
|Pancreas cancer|| ESR accelerated (more than 30 mm / hour). There are signs of anemia and
leukocytosis. With Ultrasound определяется округлое образование. Verification
The diagnosis is carried out according to the results of a biopsy.
|Type 1 diabetes||Blood sugar is higher than 6.1 mmol / l. Glycated level
гемоглобина > 6,5%.
|Cystic fibrosis||Reduced fecal elastase. Positive sweat test to increase
chlorides and DNA diagnostics.
|Pancreatonecrosis||These laboratory diagnostics coincide with acute
pancreatitis. On Ultrasound – признаки деструкции glands.
|Pancreatic cyst||Slightly increased levels of enzymes in the blood and urine. Ultrasound
detects fluid formation. Verification диагноза при