Dishomeostatic phenomena in acute pancreatitis of variable severity

Abstract

Acute pancreatitis remains one of the most dangerous pathologies in the structure of emergency abdominal surgery. This is due to many reasons, including an increase in the frequency of destructive forms of the disease, high mortality, and frequent unfavorable outcomes. The aim of this study was to investigate a number of leading components of homeostasis in patients with acute pancreatitis of varying severity. A retrospective study was conducted on 50 patients with acute pancreatitis of diff erent severity levels who were hospitalized at the Republican Clinical Hospital named after S.V. Katkovа (Saransk, Russia). The patients were divided into groups: the fi rst group (control, n = 30) consisted of patients with mild acute pancreatitis, and the second group (main, n = 20) consisted of patients with severe acute pancreatitis. The study evaluated the endogenous intoxication syndrome, the activity of lipid peroxidation and phospholipase systems, microcirculation status, liver function, and the activity of the coagulation-lytic blood system. The results showed that in the early stages of acute pancreatitis, several pathological processes were observed: the development of endotoxemia syndrome, activation of lipid peroxidation and phospholipase systems, microcirculation disorders, changes in the coagulation and fibrinolytic links of the hemostasis system, and liver function suppression. The severity of these disorders was associated with the severity of the pathology. In cases of mild severity, the changes in the parameters studied were reversible, while in severe cases they were stable and oftenirreversible. The presence of toxemia, oxidative stress, dysmicrocirculation, and hemostatic disorders should be considered as risk factors for disease progression and complications.