Influence of enzymatic parapancreatitis on the early phase of acute destructive pancreatitis

Abstract

Introduction. One of the most significant components of acute destructive pancreatitis (ADP) is enzymatic parapancreatitis (EP). The severity of the defeat of the retroperitoneal tissue from the early stages of the disease largely determines its course.The objectivewas to assess the features of the evolution of the pathological process in the retroperitoneal tissue in ADP and the effect of EP on the course of phase I of ADP.Methods and materials. 63 cases (ADP) without enzymatic peritonitis were analyzed. The average age of patients was (46.6±3.2) years (p≤0.05). The sum of points according to the express diagnostic scale of the SPb I. I. Dzhanelidze RIEM was (3.7±0.2) points (p≤0.05). The average time from the onset of the disease to the start of therapy was 2 days (from 7 to 1 day).Results. Types of EP at admission were distributed as follows: type B – 17.5 % (n=11) of cases, type C – 44.4 % (n=28) of cases, type D – 30.2 % (n=19) of cases, type E – 7.9 % (n=5) of cases. Spearman’s rank correlation coefficient for assessing the relationship between the severity of the condition and the type of parapancreatitis was 0.069. Infiltrative parapancreatitis (IP) was formed in 93.4 % of cases. The types of infiltrative parapancreatitis (pancreatic infiltrate) were distributed as follows: type A – 12.3 % (n=7) of cases, type B – 21.1 % (n=12) of cases, type C – 36.8 % (n=21) of cases, type D – 19.3 % (n=11) of cases, type E – 10.5 % (n=6) of cases. There was a pronounced relation between the severity of the patient’s condition and the prevalence of IP, the Spearman’s rank correlation coefficient was 0.82.Conclusions. EP is formed in most cases of acute destructive pancreatitis and is evolutionary. It has a significant effect on the severity of the patient’s condition and the course of acute destructive pancreatitis in the infiltrative phase of the disease.