DIAGNOSIS OF CHRONIC PANCREATITIS AND FUNCTIONAL DISORDERS OF THE PANCREAS IN DISEASES OF THE DUODENUM
DOI:
https://doi.org/10.11603/1811-2471.2017.v1.i3.8167Keywords:
pancreas, chronic pancreatitis, duodenum, motor phases, inter-digestive period.Abstract
The paper presents the results of the investigation of the tonic and functional activity of the pancreas in the inter-digestive period (IDP) in patients with chronic pancreatitis (CP) with concomitant duodenal pathology (CDP).
The aim. To determine the condition of the prostate in IDP in patients with HP in cases of CDP with the use of the method of polymorphism and ultrasonography in the monitoring mode.
Results. A study using this technique showed that the size and echostructure of the prostate is not constant in patients, as in healthy patients. They vary depending on the phases of the IDP duodenum. In healthy glands, there is the greatest in the ІІ-th phase of irregular motor, lasting (56.8 ± 4.1) minutes, and in the ІІІ-th phase of rhythmic contractions, lasting (7.6 ± 0.8) minutes - it is the lowest, and its echost structure, at the same time, it increases. The fluctuations in the size of the pancreas relative to the IDP phases, on average, are: in the head region (3.0 ± 0.1) mm, in the body region - (6.0 ± 0.4) mm and in the tail region - (7.0 ± 0.2) mm. In patients with CP, fluctuations in the size and echostructure of the gland depend on the severity and duration of the underlying disease, as well as the type of concomitant dyskinesia of the duodenum. When gptomotor dyskinesia, characteristic of AD and chronic disturbance of duodenal patency, we did not observe pronounced dynamics in changes in the size of the gland and echostructure (P <0.05). In patients with CD and hypermotor dyskinesia of the duodenum, a decrease in the size of the pancreas and an increase in its echostructure in the ІІІ and in the ІІІth phase of motility (Р <0,05) is revealed. In patients with HP, especially with severe course and duration of the disease, more than 15 years, changes in size and ehostruktury in accordance with the phases of IDP - was not detected (P <0.05). The data of ultrasonography of the prostate in the dynamics in these patients corresponded to the form and stage of СP.
The use of this technique in our study allowed only 29.0% of the examined patients to identify CP, confirming its presence with clinical, laboratory instrumental studies, in the remaining 71.0% sent to a clinic with a diagnosis of СP, changes from the prostate are considered functional, secondary, clinically relevant hypo- or hypermotor dyskinesia duodenum.
Conclusions:
1. Indicators of the phase tonic activity of the prostate in IDP - are important criteria in the differential diagnosis of organic lesions, in particular in СP, and its functional state, corresponding to motor phases and the type of dyskinesia of the duodenum.
2. To obtain objective information about the condition of the pancreas in ultrasound, it is necessary to take into account the duration of IDP (in nonsensical 90 minutes), the phase changes in the size and echostructure of the gland and to conduct the study three times with an interval of at least 30 minutes.
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