Deformation of the pancreas: what is it?

Pancreatitis. Causes, diagnosis, treatment, Pancreas: Structure, Functions. The role of the pancreas in the body August 10, 2012 118730

An ultrasound revealed
diffuse changes in the pancreas and is this scary? What diffuse changes in the pancreas and how dangerous it is for health you will learn by reading this article.
What is the pancreas, where is it located and what functions does it perform in the body? You can read here >>

Functions of the gland

The tissues of the gland contain special endocrine cells. They are responsible for the production of the hormones glucagon and insulin, and are also involved in carbohydrate metabolism. The first of them increases blood sugar levels, and the second lowers it.

The role of the pancreas for the body is enormous. After all, the process of digesting food and its availability to tissue cells of the whole body greatly depends on its activity. Therefore, damage or modification of the gland is extremely undesirable for the body as a whole.

The production of pancreatic hormones is influenced by the hormones secretin, cholecystokinin and gastrin, created by the cells of the upper rectum and stomach.

Deformation

If the bend of the gland is non-pathological (except in rare cases), then the deformation should be monitored over time. Main causes of deformation:

Deformation does not always entail the development of severe pathology or is its manifestation. But it must be identified when the child is still small. This is necessary for further correction in the event of the development of other pathological changes.

Since the pancreas is a rather vulnerable organ, the numerous pathologies that develop in it can lead to changes in the size and shape of the organ - deformation, which can occur with or without displacement of the gland.

In acute pancreatitis, as a result of swelling of the gland, it may move slightly upward. As a result, its shape changes: this can be expressed in an angular bend or multiple bends. Such deformation is more common when the process is chronic.

Deformation develops in the presence of cysts - liquid formations limited in the organ tissue by a capsule. The cyst can reach different sizes, does not cause any subjective sensations - the baby feels normal, so it cannot be detected without additional diagnostic methods. The cyst is an incidental finding during ultrasound. Congenital cysts are found in children.

Polycystic disease is a large number of cysts of different sizes. Reminds me of a honeycomb. It is found during a generalized process in the parenchyma of the liver, spleen, kidneys, and ovaries.

Another cause of deformation is tumor. It can develop in any part of the gland. In this case, the contours of the organ can be greatly disrupted, the boundaries become lumpy and unclear. It is rarely diagnosed in children.

Developmental anomalies play a role in the bending of the pancreas in a child from birth. They do not depend on how the pregnancy proceeded. With all congenital pancreatic defects, the newborn feels normal. This doesn't bother him.

The ring-shaped pancreas surrounds the duodenum at any level, leading to obstruction. It is difficult to differentiate from pancreatic head cancer that grows into the intestinal wall.

Aberrant gland - a rounded formation up to 2.5 cm is found in the wall of the duodenum or gallbladder, similar in echogenicity to pancreatic tissue. But it is rare in children.

Duplicate pancreas - cases of a body and tail with one head of the pancreas, as well as two complete glands located in parallel, have been described.

In case of injury, the gland increases in size on the second day. It enlarges and loses its contours on ultrasound. A round formation without clear contours is determined - hematoma or necrosis, disrupting the correct shape of the gland. This picture is observed with a mild closed injury.

In case of severe injury accompanied by a rupture, in the first hours only the head or part of the body is identified. Subsequently, due to bleeding and leakage of pancreatic juice, the contours become blurred, and the organ increases significantly and unevenly in size.

In medical terminology, there is no concept of bend, bend, or inflection of the pancreas. Elastic tissues allow the organ to bend, straighten and even curl into a ring. The diagnosis of bending of the pancreas does not exist due to the absence of a threat to the health and life of the patient. A bend is dangerous only if the pancreas encircles the duodenal bulb in a ring - this is accompanied by clinical manifestations.

Location

This organ is an elongated formation located in the abdominal cavity behind the stomach, next to the duodenum.

The length in adults reaches up to twenty-two centimeters, and the width in the head area is up to nine. The mass of the gland is from seventy to eighty grams.

Important. The area of ​​the gland adjacent to the duodenum is called its head. The duodenum goes around it like a horseshoe.

The body of the gland is separated from the head by a specific fold in which the portal vein is located, collecting blood from the intestines, spleen and stomach and directing it to the liver.

Next, after the head, the APPD region (accessory pancreatic duct) begins. This duct in most people connects with the main duct, and only in forty percent of cases with the duodenum through the MDS (small duodenal papilla).

However, it is still impossible to say unambiguously what shape the iron has. Some deviations from the classical form of this organ are common and are not pathological. It is worth noting that the organ moves slightly when the body position changes. So, if a person is lying down, then the gland will move a little lower, and if he is standing, then the shift will occur towards the back, i.e. deep down.

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Sometimes a person is faced with a pathological process such as gland deformation. Like deformation of any organ, such a change can lead to serious consequences for the body. Therefore, it is important to know what kind of condition this is - deformation in the pancreas and how to diagnose it.

The pancreas is capable of not only changing its location, deviating from the initial position when the body moves, but also arching and also slightly shrinking. This change in its shape is physiological and is not a pathology. Therefore, any curvature of this organ of the digestive system should be considered a variant of the norm.

Important. Pancreatic curvature is often diagnosed in children. However, with age, this phenomenon disappears without a trace.

Pancreatic atrophy

Conservative activities

In case of pancreas atrophy, diet therapy is necessarily prescribed.
The diet should be low in fat. Enough attention should be paid to protein-energy deficiency and correction of hypovitaminosis. A mandatory measure is to completely stop smoking, since nicotine disrupts the production of bicarbonates by the pancreas, as a result of which the acidity of the contents of the duodenum significantly increases. The main direction of treatment for this pathology is the replacement of exocrine and endocrine secretions of the pancreas. To compensate for impaired cavity digestion processes, a gastroenterologist prescribes enzyme preparations. To achieve a clinical effect, drugs must have high lipase activity, be resistant to the action of gastric juice, ensure rapid release of enzymes in the small intestine, and actively promote cavity digestion. Enzymes in the form of microgranules meet these requirements.

Since it is lipase that loses activity most quickly of all pancreas enzymes, correction is made taking into account its concentration in the drug and the severity of steatorrhea. The effectiveness of treatment is assessed by the content of elastase in feces and the degree of reduction of steatorrhea. The action of enzyme preparations is also aimed at eliminating pain, reducing secondary enteritis, creating conditions for normalizing intestinal microbiocenosis, and improving carbohydrate metabolism.

Correction of endocrine insufficiency is carried out through insulin therapy. With pancreatic atrophy, the islets of Langerhans are partially preserved, so insulin is produced in the body, but in small quantities. The dosage and regimen of insulin administration are determined individually depending on the course of the pathology, etiological factor, and data from daily blood glucose monitoring. The administration of enzyme preparations significantly improves the function of the pancreas in general and carbohydrate metabolism as well. Therefore, the insulin therapy regimen is determined depending on the dosage and effectiveness of enzyme replacement therapy.

An important condition for the effective correction of digestive functions is the normalization of intestinal microbiocenosis, since the intake of enzymes creates favorable conditions for the colonization of pathogenic flora. Probiotics and prebiotics are used. Injection vitamin therapy, as well as magnesium, zinc, and copper preparations, are required.

Surgery

Surgical treatment of this pathology is carried out in specialized centers. Transplantation of the islets of Langerhans is performed, followed by removal of the gland and enzyme replacement therapy. However, since atrophy is often a consequence of severe illnesses with a pronounced impairment of the patient’s general condition, such treatment is rarely carried out.

Pancreatic deformity: what is it?

A modification in which the gland literally twists around the initial part of the small intestine is called a “deformation in the pancreas.” This creates a serious disruption in the proper functioning of the digestive system, when the movement of food through the digestive tract becomes impossible.

Today's medicine explains the rare deformation of gland tissue for three reasons:

• Consequences that arise when a tumor tumor appears in the tissues of the gland. In this case, deformation of the gland itself is a sign of a neoplasm. On ultrasound images, the gland looks greatly enlarged, its contours are modified. The appearance of such a picture is a reason for serious research into the body.
• Consequences that occur when a cystic formation (cyst) appears in tissues. However, it is impossible to say unequivocally that a cyst is a symptom of this disease. Its appearance should initiate a series of studies of the body, during which the true causes of the disease will be determined. Cysts are detected using ultrasound.
• The consequences that pancreatitis causes in the body. With this disease, the pancreas first takes on an angular shape and moves slightly upward. If pancreatitis of the pancreas is diagnosed in time, then its deformation stops, and after some time it takes on its usual shape and location. A number of symptoms that occur in a person help to identify acute pancreatitis. Inflammation, which has become a chronic process, often causes final deformation of the pancreas.

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Causes of deformities

Bending of the gland, unlike deformation, does not lead to anatomical and functional disorders. Most often, the cause of curvature is the position of the body and the mobility of the gland due to its continuous growth.

The head of the pancreas encloses the pyloric part of the duodenum in a ring

Deformation is associated with structural disorders in the organ, which, in turn, cause functional deviations. Among the reasons that provoke changes in the shape of the pancreas are:

• pancreatitis (acute, chronic);
• adhesive process in the area where the organ is located;
• diabetes;
• infections (mumps, adenovirus, herpesvirus, rubella, ECHO and Coxsackie, influenza);
• injury;
• obesity;
• cystic process;
• disruption of the outflow of pancreatic juice in diseases of the duodenum and biliary tract;
• cystic fibrosis;
• tumor formations;
• congenital developmental anomalies (hypoplasia, hyperplasia, ring-shaped head);
• toxic damage.

These processes lead to tissue damage, replacement of areas of necrosis (death) with connective tissue, deformation and disruption of the digestive and endocrine functions of the organ. The pancreas increases in volume, loses its usual shape, becomes lumpy, and acquires curves that do not disappear over time or when changing body position.

Diagnostics

Diagnosis of the gland is a rather complex process, because... it is located deep in the area behind the peritoneum. The palpation method is not suitable for this organ in most cases. This becomes possible only if it is increased excessively.

If a patient has acute pancreatitis, changes in the gland are identified based on his complaints and a list of laboratory tests. In this case, the following are diagnosed:

• urine,
• blood,
• cal.

For a more in-depth analysis of the tissues of this organ, hardware diagnostics are used:

• fibrocolonoscopy;
• ultrasonography;
• magnetic resonance and computed tomography;
• esophagofibrogastroduodenoscopy.

Most often, for this disease, doctors prescribe an ultrasound of the abdominal cavity and the area behind the peritoneum. However, research does not always end there. There are cases when the patient’s tests are normal, but no special clinical signs are detected. Then, in addition to ultrasound, MRI (magnetic resonance imaging) and CT (computed tomography) are prescribed. When the doctor believes that there are neoplasms in the tissues of the gland, he prescribes an MRI and histological examination.

Important. In addition, when the lumen of the duodenum is compressed by pancreatic tissue, endoscopy is prescribed.

Symptoms of the disease

As a rule, changes in the shape of the pancreas are not accompanied by any discomfort. Unpleasant sensations appear only at a severe stage of the disease, when the organ bends around the duodenum.

Doctors identify the following symptoms of a bent pancreas:

• Acute pain in the abdominal area;
• Vomiting and diarrhea;
• Rejection of bile into the stomach;
• Increased amount of saliva produced;
• Rapid breathing.

These signs indicate the need to undergo a medical examination as soon as possible, but the final diagnosis is made by a qualified specialist.

Symptoms of atrophy

The disease is characterized by swelling of the pancreas, poor circulation, the occurrence of necrosis and the formation of cysts. For these reasons, external exocrine insufficiency occurs. The body's absorption of vitamins and microelements is impaired, the skin gradually turns pale, taste buds are distorted, and the muscles become loose and flaccid. Atrophic processes can last up to 10–15 years from the diagnosis of chronic pathology. The main complaints of patients are reduced to disorders of the digestive system.

And also this type of disease is characterized by the following symptoms:

• Lack of appetite.
• Bloating after eating.
• Feeling of nausea, turning into vomiting.
• Pale and dry skin.
• Discharge of feces with a high fat content (steatorrhea), diarrhea.
• Red tint to the surface of the tongue, plaque, dental imprints.
• Intense pain under the ribs, mainly on the left side.
• Unexplained weight loss.

IMPORTANT! If you notice these symptoms in yourself, you should immediately consult your doctor.

Pale and dry skin may indicate a problem with the pancreas; if you notice these symptoms, consult a specialist

Methods for diagnosing pathology in children

The retroperitoneal location of the pancreas does not make it possible to palpate it and determine changes in size, shape, and additional formations. Pathological changes in it do not always manifest themselves as complaints and clinical symptoms.

In cases of deformity associated with acute or chronic pancreatitis, a diagnosis can be made based on:

• complaints;
• a detailed history;
• laboratory data.

The disease has clinical manifestations that are not specific, but on their basis an inflammatory process can be suspected:

• acute onset;
• febrile temperature (38–39 degrees);
• pain in the navel area, in the left hypochondrium or surrounding pain;
• nausea and vomiting that does not bring relief;
• diarrhea.

Laboratory tests will help confirm the diagnosis:

• general blood analysis;
• biochemical blood and urine tests for elevated levels of amylase and other enzymes - a sign of pancreatitis;
• coprogram;
• fecal elastase analysis.

If even after this the picture does not clear up, they do sonography (ultrasound), and, if necessary, CT. Ultrasound reveals a swollen organ, a change in its echogenicity and a slight curvature with an upward displacement of the organ.

In other cases of deformity, the main diagnostic method is ultrasound or CT, since clinical manifestations are most often absent and laboratory data are uninformative. If a tumor is suspected, an MRI is performed and a biopsy with histological examination is performed.

Clinical picture

Symptoms during bending appear only in the case of organic tissue damage with the development of permanent deformation. With a bend of the pancreas that is functional (non-pathological) in nature, no signs of disease are observed.

The main reason for the development of deformity is chronic pancreatitis, which is the outcome of an acute process of inflammation in the tissues of the gland. Therefore, parents should be alert to the appearance of symptoms such as:

• sharp pain in the left hypochondrium, side or around the navel (in small children), sometimes of a girdling nature;
• irradiation (spread) of pain to the lumbar region, under the shoulder blade;
• nausea;
• uncontrollable repeated vomiting;
• increased body temperature;
• flatulence;
• bowel dysfunction (diarrhea, constipation or their alternation);
• local tension in the muscles of the anterior abdominal wall.

With congenital pathology of the organ, symptoms appear from birth and are manifested by the following conditions:

• poor weight gain;
• frequent, profuse regurgitation, unrelated to neurological diseases;
• admixture of bile in vomit;
• baby's anxiety;
• sluggish breast or pacifier sucking, refusal to feed;
• bloating;
• meconium ileus in the neonatal period;
• large stools with a lot of fat;
• prolonged jaundice;
• respiratory pathology.

With a ring-shaped head of the pancreas, signs of high intestinal obstruction may occur. In this case, on the first day there appears abundant regurgitation with an admixture of bile (green), bloating of the upper abdomen, and absence of peristaltic sounds in the intestines.