Acute pancreatitis (АP):

АP is an aseptic inflammation of a

demarcation nature, which is based on the processes of necrobiosis of pancreatocytes and enzymatic autoaggression with the subsequent development of necrosis, degeneration of the gland and the addition

of a secondary infection.

АP classification:

1.edematous (swelling of the pancreas head) (interstitial)

2.destructive: hemorrhagic necrosis, fatty necrosis (i.e. pancreatic necrosis) 3.purulent

Etiology:

-Gallstone disease (40%)

-Alcohol (30%)

-Injuries, operations, endoscopic examinations

-Drug toxicity (azathioprine) -Hypertriglyceridemia

-Infectious diseases (viral hepatitis, mumps)

- Sudden, severe pain at the top half of the abdomen, often encircling, radiate to the lower back, under the left shoulder blade, sometimes behind the breastbone. Often after taking oily food and alcohol.

-Nausea, vomiting, not relieving.

-Constipation, diarrhea is possible.

-Hypersecretion.

-The skin is pale, sometimes icteric.

-Flatulence. Temperature increase.

-Painful abdomen in the epigastrium, then symptoms of an acute abdomen join.

Forced position of a patient with acute pancreatitis:

1.Acute vascular insufficiency (shock, collapse)

2.Mono- or polyserositis: peritonitis (limited, spilled), pleurisy, pericarditis.

3.Myocardial infarction.

4.Dynamic intestinal obstruction.

5.Hematoma of the abdominal cavity.

6.Abscesses: interintestinal, retroperitoneal, subphrenic, perirenal

7.Cysts.

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas, characterized by subtotal necrosis in combination with diffuse or segmental fibrosis and the development of varying degrees of severity of functional impairment, which remain and progress after the cessation of exposure to

etiological factors.

Etiological factors:

1.Alcohol

2.Cystic fibrosis

3.Chemicals and medicines

4.Hyperlipidemia

5.Hypercalcemia

7.Hereditary predisposition

8.Deficiency of antioxidants in iron

9.Malnutrition (protein and fat) 10.Medicines: azathioprine, furosemide, hypothiazide, mercaptopurine, estrogens, tetracycline, methyldopa.

Clinical classification:

-Chronic recurrent pancreatitis (occurs most often - 60% of cases).

-Chronic painful pancreatitis (with constant pain; occurs in 20% of cases).

-Pseudotumorous chronic pancreatitis (hyperplastic form; found in 10-15% of cases).

-Latent (painless) chronic pancreatitis (occurs in 5-10% of cases).

By etiology:

-chronic obstructive

-calcifying

-inflammatory (parenchymal) pancreatitis

CP in the acute phase:

I. Pain syndrome. The pain associated with acute inflammation of the pancreas is localized in the center of the epigastric region, often spreads to the right and left hypochondrium with irradiation to the back or has a girdle character, increases in the supine position and weakens in the sitting position with a slight forward bend. The pain can also radiate to the region of the heart, mimicking angina pectoris, to the left shoulder blade and left shoulder, and sometimes to the