Diagnosis of Acute Biliary Pancreatitis
Introduction. Increase in the incidence of cholelithiasis causes enhaced number of patients with acute biliary pancreatitis in surgical units. It is important to improve the diagnosis of this pathology. Materials and methods. Clinical examination and treatment was conducted involving 126 patients with acute biliary pancreatitis. Among the examined patients there were 32 men (25.4 %), 94 women (74.6 %). No one among the men were younger than 30 years. Patients aged over 61 were 13.4 %. Results and their discussion. In 45.2 % of patients with acute biliary pancreatitis in anamnesis cholelithiasis developed over 6–10 years, only 3.9 % had new cholelithiasis within the last year, while calculus in bile-excreting system was first diagnosed in 15.1 % patients. This indicates that it is necessary for more active surgical tactics when cholelithiasis is detected and to limit the indications for conservative treatment of this pathology. Patients with acute biliary pancreatitis have most common manifestations of hemodynamic (62.7 %) and enteral (88.9 %) syndrome, SIRS (91.3 %), hyperenzymemia syndrome (100.0 %) and hepatic dysfunction (68.3 %). Roentgen signs (symptom of Gobiet, Stuart, sentinel loop, Poppel, Tobia) were common and of high significance. Roentgenography of thoracic organs and abdomen, ultrasonography of panсreatico-hepato-biliary zone and fibrogastroduodenoscopy are key instrumental methods of high informative value that determine the diagnosis of acute biliary pancreatitis in the Admission Department. Conclusions. For rapid and accurate diagnosis of acute biliary pancreatitis a complex evaluation of clinical symptoms and results of laboratory and instrumental investigations should be performed.
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