Anatomy

Where it is, how it hurts and how to treat the pancreas

Pathological conditions of the pancreas adversely affect the various functions of the body and can manifest themselves as diverse dyspeptic disorders and severe pain syndrome. This gland, despite its small size and weight, plays a very important role, since it is directly involved in the processes of digestion and is responsible for the production of the necessary enzymes, as well as insulin.

Any functional failures in the work of this body can cause very dangerous consequences, so you should seek medical help at the first signs of gland diseases.

Functions of the body

The pancreas is located deep in the abdominal cavity and tight to the walls of the stomach. In adults, iron is an organ weighing approximately 70–80 g, and its dimensions are about 25 cm. It performs two main functions:

  1. The exocrine function that characterizes the pancreas in that it is responsible for producing pancreatic juice, which is necessary for a full digestion process. It is in the pancreatic juice that the most important enzymes are present that contribute to the breakdown of the main substances entering the body. In addition to enzymes, this fluid contains specific substances that are able to neutralize the acidic environment of the juice produced by the stomach and protect its mucosa from a variety of damage.
  2. Endocrine function, which is the production of the hormone glucagon insulin. These substances play a direct role in carbohydrate metabolism and regulate blood sugar levels. When a person has insufficient insulin production, he develops such a dangerous disease as diabetes.

The main causes of pathologies

The main predisposing factors for the development of various diseases of the pancreas are:

  1. All possible pathologies of the duodenum or biliary tract.
  2. Difficult outflow of secretion, which is a consequence of tumor processes.
  3. Mechanical injuries of the pancreas.
  4. Anomalies of congenital nature (genetic factor).
  5. Chronic alcoholism.
  6. Some infectious diseases.
  7. Effect of carcinogens and various toxic substances.
  8. Wrong or poor quality food.
  9. Psychosomatic factors associated with the presence of severe stress.

The effect of alcohol on the pancreas is very ambiguous. In certain cases, patients who suffer from chronic alcoholism often avoid inflammatory processes, while taking even a small amount of alcohol for non-drinking healthy people can sometimes turn out to be fatal, which will result from destructive changes in the pancreas.

Very often it happens that the damage of an organ is directly related to the defects of the anatomical structure (excesses, incorrect structure of the ducts, hypoplasia, etc.), severe infections of the fetus and mother during pregnancy. In addition, in the development of gland diseases a certain role can be played by the age and sex of the patient, the ecological situation, his lifestyle, the harmfulness of production, as well as the presence of some associated diseases (diabetes, cholecystitis, hepatitis, etc.).

Before considering the treatment of the pancreas, we describe the symptoms.

Pain syndrome

Pain in the event of pathologies of the gland can be dull and pulling, or sharp and intense (in acute inflammatory processes). They are observed in the epigastric region and pursue the patient constantly, can be in the nature of attacks and manifest themselves with changes in the usual way of eating (for example, after eating fatty or spicy foods, alcoholic beverages, overeating), as well as after stressful situations. The pain, as a rule, gives in the left hypochondrium, the back and the scapula, or has a general shingles character in pancreatic diseases. The signs don't end there.

Pain syndrome may decrease when taking a certain posture, for example, lying on your left side with your legs bent at the knees. To relieve the suffering of the patient by using cold compresses, while the use of heat contributes to a sharp increase in pain and the further development of the inflammatory process. With pancreatic necrosis, such a syndrome is so strongly pronounced that it can sometimes lead to a painful shock in a person, which (like the underlying disease) is life-threatening.

Dyspeptic disorders are usually accompanied by a lack of appetite, vomiting, nausea, diarrhea or constipation. At the initial stage, abdominal distention, delayed stool, flatulence can occur, which is directly related to enzyme deficiency and lack of bile acid production. A few days after constipation, frequent loose stools may occur. At the same time, the patient is suffering from painful thirst, weakness, dry mouth, and the temperature and sweating may also increase.

What is accompanied by pain in the pancreas?

This body reaction is caused by its general intoxication and, as a rule, does not bring relief. At first, stomach contents may be present in the vomit, and after that only bile is released. Frequent bouts of vomiting can cause a loss of electrolytes and fluids, leading to dehydration.

In some particularly severe cases, this condition may be accompanied by a sharp decrease in blood pressure indicators, heart rhythm disturbances. In the event of acidosis, the patient may lose consciousness, which in most cases is a consequence of hypovolemic shock.

The skin at the same time become jaundiced. This phenomenon is due to the fact that the edematous gland begins to squeeze the bile ducts. In addition, due to severe intoxication of the body and the occurrence of respiratory disorders, some cyanosis appears in the area of ​​the nasolabial triangle, as well as in the navel.

In addition, certain specific symptoms may be observed during palpation of the abdomen, which only a specialist can determine and evaluate. Laboratory tests, instrumental methods for the diagnosis of pancreatic pathologies, as well as the determination of hormonal disturbances can also help to establish the diagnosis.

Where is the pancreas

The pancreas is located in the abdominal cavity (approximately the level of the first and second lumbar vertebrae). The organ is located behind the stomach and tightly adjacent to it and the duodenum.

If you hold a projection on the side of the abdominal wall, its location is about 5-10 cm above the navel.

The head of the gland is surrounded by the duodenum, which surrounds it in the shape of a horseshoe. Through the pancreas-duodenal arteries provides blood supply to the pancreas.

How does the pancreas hurt?

Often there are diseases of the pancreas, such as pancreatitis, adenocarcinoma, stones in the excretory ducts, necrosis and diabetes.

About pancreatitis - inflammation of the pancreas, as well as its damage, is indicated by the following symptoms:

  • pain in the area under the ribs in the left side,
  • weakness,
  • increased sweating
  • cardiopalmus,
  • high temperature
  • nausea, vomiting,
  • yellowness of the skin and eye proteins,
  • diarrhea,
  • possible shock condition.

The pain during exacerbation of pancreatitis appears suddenly, has a sharp shingles - spreads along the entire left side and can spread behind the back. Antispasmodics cannot relieve pain, some reduction is possible in a sitting position and in a tilt slightly forward. Sometimes the patient feels “bursting out” from the inside, physically feels an increase in the gland and pressure in the area of ​​the ribs that interferes with proper breathing.

With increasing pain, the gag reflex becomes stronger. Vomiting attacks may precede the onset of pain. Often vomiting appears in the morning either as a reaction to food intake, i.e. as a result of stomach cramps. After vomiting, which has a bitter or sour taste, relief comes for a while. Emetic urges can be both systematic and appear periods.

In the event of an acute attack of pancreatitis, you should immediately go to the hospital, where doctors will prescribe inpatient treatment. Without taking action, the disease will not pass. With prolonged attacks of vomiting, the stomach is cleaned with a probe and special enzymes are administered to eliminate the aggressiveness of the pancreas and stomach.

Treatment of the pancreas at home

When pancreatitis is in the exacerbation stage, full starvation is required for 24-46 hours. During this time, the production of pancreatic juice will be reduced to a minimum, reducing the load on the pancreas. A few days before the onset of exacerbation, a person loses his appetite. At this time, it is required to drink non-carbonated mineral water, rosehip decoction or baking soda solution.

Symptoms of acute pancreatitis include vomiting and abdominal pain, which continue for several days. The same symptoms can signal cholecystitis, appendicitis, intestinal obstruction or a stomach ulcer. To determine the correct diagnosis requires an immediate visit to the doctor. Acute pancreatitis is treated only in stationary conditions.

Folk remedies

An effective and affordable method of treating the pancreas at home is to clean the organ and its vessels with a diet. In diseases of the pancreas, sweet foods are removed from the diet (only honey is allowed), fatty, fried and spicy foods, and alcohol. It is necessary to give up smoking. In food, you must introduce restrictions, you can not allow overeating. Porridges are useful, especially buckwheat and oatmeal. Drinking regimen is also important. Water needs to be consumed a lot, you can add some freshly squeezed lemon juice to your drinking water.

To cure the pain of the pancreas will help the following folk remedies.

Yogurt compress

It is used for pain and inflammation during an attack of pancreatitis. Soft tissue is moistened in clabber and placed a compress on the stomach in the stomach. It remains to attach the top of a plastic bag and wrap a woolen scarf or a scarf. The procedure is carried out for about six weeks.

Lemon and Garlic Mix

For the preparation of folk remedies you will need 1 kg of lemons, which are used with the peel, 300 grams of garlic and the same parsley. All ingredients are ground in a meat grinder. Lemons are preliminarily removed. The mixture is stored in a refrigerator in a glass container and taken three times a day for 1 tsp. a quarter of an hour before eating food.

To enhance the effect, drink down the mixture is recommended useful infusion. Prepare it as follows: take in equal proportions blueberry, lingonberry, strawberry leaves, corn silk, bean pods. One tablespoon of the resulting collection is poured into a thermos with one glass of boiling water and infused overnight. A glass of infusion is divided into three parts and drunk with garlic mixture. The treatment is carried out for three months.

Milk decoction of parsley

Rinse well with 800 grams of parsley, finely chop and pour boiling milk. To prepare the decoction use enamelware. Milk must completely cover the greens. Broth languishing over low heat, you can not allow boiling milk. This portion is enough for a day. Reception is carried out on 2 tablespoons every hour.

Medical supplies

For the treatment of diseases of the pancreas are used groups of medical drugs.

Antispasmodic drugs are used: "Drotaverin", "No-Shpa", "Baralgin", "Papaverin". In case of moderate pain, Iburofen or Acetaminophen will help. The use of analgesics ("Aspirin" or "Paracetamol") and antihistamines, such as "Dimedrol", "Platifillin", "Atropine" is permissible.

To reduce the production of enzymes, patients are prescribed "Contrycal", "Aprotinin". When an acute attack goes away or chronic pancreatitis requires enzyme therapy, which will help to normalize digestive function. In this case, appoint: "Mezim", "Panzinorm", "Pancreatin", "Festal", "Creon". Their use is contraindicated in allergies to pork protein, as this component is the basis. In childhood, such a reaction can provoke an intestinal obstruction, then plant origin will come to the rescue: Somilaz, Unienzyme, Somilaz, they are based on papain or rice fungus.

Enzyme use occurs after a meal. The doctor prescribes the required dosage individually. In some cases, after a course of treatment, maintenance therapy is prescribed, which may be necessary throughout life. In the case of a violation of the exocrine function, drugs regulating the blood sugar level are used - insulin preparations.

In diseases of the pancreas, one cannot resort to self-treatment, which can provoke such diseases as diabetes mellitus, necrosis, and blood infection.

To relieve pain and prevent irritation, medical products in the form of gels or suspensions are used. Their task is to neutralize hydrochloric acid ("Phosphalugel", "Almagel") or reduce its production ("Omez", "Proceptin", "Contralok", "Omeprazole", "Otsid", "Gastrozol").

Pancreas Sizes

The pancreas among the organs producing enzymes is the second in size after the liver. Already from the fifth week of pregnancy begins its formation. The neonatal gland is 5 cm; by the year it reaches 7 cm, and in a 10-year-old child it is about 15 cm. The final dimensions of the pancreas are formed by the age of sixteen.

The widest part of the pancreas of an adult is the head: in width it reaches 5 cm, thickness is in the range of 1.5-3 cm. The body is the longest part of the body, which is 1.7-2.5 cm wide. The normal length for the tail - Up to 3.5 cm, and width - about 1.5 cm.

To identify pathologies in medicine, ultrasound is used, as a result of which the shape and size of the organ, indicating its condition, are determined. Other research methods are difficult because the pancreas is located quite deep.

The structure of a healthy body is homogeneous. Minor changes in the size of the head, tail or body can be considered the norm in the case of excellent biochemistry blood test results.

Exocrine function

One of the most important roles of the pancreas in the body is the production of pancreatic juice, which consists of salts, water, enzymes (proenzymes).

Pancreatic enzymes include:

  • Trypsin and chymotrypsin (help digest protein)
  • Amylase - breaks down carbohydrates,
  • Lipase - completes the process of splitting fat, which were under the influence of bile from the gallbladder.

The composition of the pancreatic juice are trace elements - acid salts, which provide an alkaline reaction.It neutralizes the acid of food coming from the stomach and helps to absorb carbohydrates.

Pancreatic juice secretion is directly related to food intake. This means that by consuming different foods, juice enzymes of different composition and volume are produced.

Endocrine function

The release of hormones into the blood - glucagon and insulin is a secretory function of the pancreas.

  • Insulin regulates carbohydrate and lipid (i.e. fat) metabolism. It promotes the flow of glucose from the blood into the cells and tissues of the body. Due to this, there is a decrease in blood sugar. Violation in the production of insulin provokes the development of diabetes.
  • Glucagon can be called an insulin antagonist, as it is designed to increase blood glucose levels. Alpha cells that produce glucagon help produce the substance lipocaine, which prevents the fatty degeneration of the liver.
  • Other essential hormones in the body are also produced, for example, ghrelin, which is responsible for appetite and stimulates food intake.

Many violations in the pancreas is easier to prevent than to cure. Avoiding bad habits (drinking and smoking) and healthy eating minimize the risk of organ disorders.

Content

Descriptions of the pancreas are found in the writings of ancient anatomists. One of the first descriptions of the pancreas is found in the Talmud, where it is called "the finger of God." A. Vesalius (1543) describes the pancreas and its purpose in the following way: "in the center of the mesentery, where the first distribution of vessels occurs, is a large glandular, very reliably supporting the first and most significant branching of the vessels." In describing the duodenum, Vesalius also mentions the glandular body, which, according to the author, supports the vessels belonging to this gut and irrigates its cavity with sticky moisture. A century later, the main pancreatic duct, Virung (1642), was described.

The pancreas is the main source of enzymes for the digestion of fats, proteins and carbohydrates - mainly trypsin and chymotrypsin, pancreatic lipase and amylase. The main pancreatic secretion of ductal cells contains bicarbonate ions involved in neutralizing the acidic gastric chyme. The secret of the pancreas accumulates in the interlobular ducts, which merge with the main excretory duct, which opens into the duodenum.

Numerous groups of cells that do not have excretory ducts are interspersed between the lobules. islets of Langerhans. Islet cells function as endocrine glands (endocrine glands), releasing glucagon and insulin, hormones that regulate carbohydrate metabolism, directly into the bloodstream. These hormones have the opposite effect: glucagon increases, and insulin lowers blood glucose levels.

Proteolytic enzymes are secreted into the lumen of acini in the form of zymogens (pro-enzymes, inactive forms of enzymes) - trypsinogen and chymotrypsinogen. When released into the intestine, they are exposed to enterokinase, which is present in the parietal mucus, which activates the trypsinogen, turning it into trypsin. Free trypsin further cleaves the rest of trypsinogen and chymotrypsinogen to their active forms. The formation of enzymes in an inactive form is an important factor preventing enzymatic damage to the pancreas, often observed in pancreatitis.

The hormonal regulation of the exocrine function of the pancreas is provided by gastrin, cholecystokinin and secretin - hormones produced by the cells of the stomach and duodenum in response to stretching, as well as the secretion of pancreatic juice.

Damage to the pancreas is a serious danger. Puncture of the pancreas requires special care when performing.

The human pancreas is an elongated lobular formation of a grayish-pinkish hue and is located in the abdominal cavity behind the stomach, closely adjacent to the duodenum. The organ lies in the upper section on the posterior wall of the abdominal cavity in the retroperitoneal space, located transversely at the level of the bodies of the I – II lumbar vertebrae.

The length of the gland of an adult is 14–22 cm, width — 3–9 cm (in the head area), thickness — 2–3 cm. The mass of the organ is about 70–80 g.

Head Edit

Pancreas Head (caput pancreatis) adjoins the duodenum, located in its bend so that the latter covers the gland in the form of a horseshoe. The head is separated from the body of the pancreas by a groove in which the portal vein passes. From the head begins the additional (santorinia) pancreatic duct, which either merges with the main duct (in 60% of cases) or independently enters the duodenum through the small duodenal papilla. one

Body edit

Pancreas body (corpus pancreatis) has a triangular (triangular) shape. In it there are three surfaces - front, back and bottom, and three edges - top, front and bottom.

Front surface (facies anterior) facing forward, to the back surface of the stomach, and a little upwards, below it limits the front edge, and from above - the top one. On the front surface of the gland body there is a bulge facing the stuffing bag - the stuffing tubercle.

Back surface (facies posterior) adjacent to the spine, abdominal aorta, inferior vena cava, celiac plexus, to the left renal vein. On the back surface of the gland there are special grooves in which the splenic vessels pass. The posterior surface is delimited from the anterior with a sharp upper margin along which the splenic artery passes.

Lower surface (facies inferiora) the pancreas is oriented down and forward and is separated from the back by a blunt posterior margin. It is located below the root of the mesentery of the transverse colon.

Tail Edit

Pancreas Tail (cauda pancreatis) has a cone-shaped or pear-shaped shape, going left and up, extends to the gate of the spleen.

The main (wirsung) duct of the pancreas passes through its length and flows into the duodenum in its descending part on the large duodenal papilla. The common bile duct usually merges with the pancreatic and opens into the intestine there or next.

Microscopic structure Edit

The structure is a complex alveolar-tubular gland. From the surface, the organ is covered with a thin connective tissue capsule. The main substance is divided into lobules, between which there are connective tissue bands, enclosing the excretory ducts, vessels, nerves, as well as nerve ganglia and lamellar bodies.

The pancreas includes exocrine and endocrine parts.

Eccrine part Edit

The exocrine part of the pancreas is represented by pancreatic acini located in lobules, as well as a tree-like system of excretory ducts: intercalated and intralobular ducts, interlobular ducts and, finally, common pancreatic ductopening into the lumen of the duodenum.

Acinus of the pancreas is a structural and functional unit of the body. According to the form, the acinus is a rounded education with a size of 100-150 microns, in its structure it contains a secretory section and insert ductgiving rise to the entire duct system of the organ. Acini consists of two types of cells: secretory - exocrine pancreatocytes, in the amount of 8-12, and ductal - epithelial cells.

Inserted ducts pass into the inter-acinar ducts, which, in turn, flow into the larger intralobular ducts. The latter continue into the interlobular ducts, which flow into the common pancreatic duct.

Endocrine Edit

The endocrine portion of the pancreas is formed lying between the acini pancreatic islets, or islets of Langerhans.

Islands consist of cells - insulocytesamong which, on the basis of the presence of granules of various physical, chemical and morphological properties, there are 5 main types:

In addition, the presence of insignificant number of cells containing gastrin, thyroliberin and somatoliberin in the islets has been shown by immunocytochemistry and electron microscopy.

The islands are compact clusters penetrated by a dense network of fenestrated capillaries arranged in clusters or cords of intrasecretory cells. The cells are surrounded by layers of the capillaries of the islets, being in close contact with the vessels, most endocrinocytes are in contact with the vessels either through the cytoplasmic processes or adjacent to them directly.

Blood supply Edit

The pancreas is supplied with blood through the pancreatoduodenal arteries, which branch off from the superior mesenteric artery or from the hepatic artery (branch of the celiac trunk of the abdominal aorta). The superior mesenteric artery provides the lower pancreatoduodenal arteries, while the gastroduodenal artery (one of the terminal branches of the hepatic artery) provides the upper pancreatoduodenal arteries. The arteries, branching into the interlobular connective tissue, form dense capillary networks intertwining the acini and penetrating the islets.

Venous outflow occurs through the pancreatoduodenal veins, which flow into the splenic gland passing behind the gland, as well as other tributaries of the portal vein. The portal vein is formed after a fusion behind the body of the pancreas of the superior mesenteric and splenic veins. In some cases, the inferior mesenteric vein also flows into the splenic vein behind the pancreas (in others, it simply connects to the superior mesenteric vein).

Lymphatic capillaries, starting around acini and islets, flow into the lymphatic vessels that pass near the blood vessels. The lymph is taken up by pancreatic lymph nodes, located in the amount of 2-8 at the upper edge of the gland on its back and front surfaces.

Acute pancreatitis

This pancreatic disease is a sudden inflammation that is accompanied by swelling and damage to the organ. In some cases, a very serious condition develops, for example, organ necrosis, accompanied by tissue suppuration and hemorrhage, which often leads to death even in intensive care.

The causes of such an acute condition can be alcohol consumption, overeating, taking certain medications, concomitant pathologies of the gallbladder. The process of inflammation is triggered by a violation of the discharge of pancreatic secretions, which provokes an increase in pressure in the main ducts. Active enzymes begin to penetrate into the tissues of the body and cause the development of edema, a violation of the excretion of digestive enzymes. As a result of these processes (instead of splitting food), enzymes begin to digest the cells of the gland.

During an acute attack of pancreatitis, a person experiences very severe pains that are poorly relieved by medication. This condition aggravates vomiting, nausea, lowering blood pressure, changes in heart rhythm. With the development of such a pathology, the patient needs emergency care and hospitalization in the hospital.

Chronic pancreatitis

The course of this disease is long and it is accompanied, as a rule, by periodic exacerbations. During periods of remission, the pain is absent, and when exacerbated, a surrounding herpes pain syndrome of varying degrees of intensity appears.

There is a decrease in appetite and nausea, there are isolated bouts of vomiting of bile or food. There is also bloating, instability of the chair, flatulence. As a rule, the exacerbation of the disease occurs due to a violation of the diet, after stress, drinking alcohol, exacerbation of gallbladder diseases, etc. What else can cause pain in the pancreas?

Pancreatic development and age

The pancreas develops from the endoderm and mesenchyme, its germ appears on the 3rd week of embryonic development in the form of protrusion of the embryonic intestinal wall, from which the head, body and tail are formed. Differentiation of the primordia to the excretory and intrasecretory parts begins from the 3rd month of embryogenesis. Acini and excretory ducts are formed, the endocrine departments are formed from the kidneys on the excretory ducts and are “lacerated” from them, turning into islets. Vessels, as well as connective tissue elements of the stroma are developed from the mesenchyme.

In newborns, the pancreas has very small dimensions. Its length varies from 3 to 6 cm, weight - 2.5-3 g, iron is slightly higher than in adults, but weakly fixed to the posterior abdominal wall and relatively mobile. By the age of 3, its weight reaches 20 grams, by the age of 10-12 - 30 g. The appearance characteristic of adults takes iron to 5-6 years old. With age, the relationship between the exocrine and endocrine parts of the pancreas changes towards a decrease in the number of islets.

Tumor Diseases

In the pancreas, hormone-dependent tumors and malignant neoplasms (cancer) can occur. Tumors of a hormonal nature are malignant and benign, develop due to an excess of hormones produced by the pancreas. Such processes are often accompanied by a violation of the metabolic process in the body.

Cancer of the gland is quite common. In the initial stages, you may experience nausea, fatty stools, lack of appetite, bloating, weight loss. The pain may be permanently aching. In the later stages, the patient's condition is complicated by frequent bouts of vomiting and profuse diarrhea, and the skin is jaundiced.

Pancreatic Cysts

When the cyst is small, the severity of pain is very weak, but if the tumor is large, it begins to compress the nerve endings in the gland, which causes acute pain. When the head of this organ is affected, weight loss, abdominal distention, and an increase in stool are noted.

In cases where a cyst forms in the body or in the tail of the gland, nausea also occurs, but constipation and discolored stools will be typical symptoms. It is even possible to feel the large-sized cyst through the peritoneal wall. With tumor suppuration, the patient's condition is complicated by hyperthermia.

When cystic fibrosis occurs acute pain in the intestinal area, there is a fat and liquid stool, the volume of which exceeds the norm. A typical symptom in this case is a decrease in appetite, dry mouth, flatulence, muscle weakness, and small crystals of salt appear on the skin.

Diabetes mellitus associated with cessation of insulin production by the gland, as a rule, is not accompanied by pain syndromes. The main symptoms of this disease are constant thirst, an increase in urine volume, itching, a sharp feeling of hunger during the development of hypoglycemic crises, nausea, weight loss, sweating.

What is the pancreas

The pancreas (PZHZH) is the internal organ of the digestive and endocrine systems, which consists of two parts: the exocrine (exocrine) and intrasecretory (endocrine).

The excretory part of the gland is represented by cells that produce pancreatic juice (acini) and an extensive system of ducts, which ensures the outflow of digestive juice from acini and its delivery to the intestine. Small ducts PZHZh merge into larger, which then flow into the main (Wirsung) duct.

The pancreatic duct system closely connects the gland with the biliary tract and the duodenum. This anatomical structure determines the fact that more than 30% of the pathologies of the pancreas are secondary and develop due to diseases of nearby organs.

The intrasecretory part of the gland is significantly inferior to the exocrine in size: its mass is not more than 2% of the total mass of the organ. This part is a small islands of endocrine tissue (islands of Langerhans), which are surrounded by the exocrine part of the pancreas. The islets of Langerhans are located mainly in the tail part of the organ.

Severe diseases of the exocrine gland can also affect the islets of Langerhans: their hormonal function may be impaired with severe inflammation of the main mass of the PZHZh parenchyma or the presence of a major cancer.

Where is the pancreas in humans

The pancreas is located in the abdominal cavity at the level of the first lumbar vertebrae (in newborns - at the level of the last thoracic). In the horizontal position of the body, it is under the stomach, which causes its name. The organ closely adjoins the duodenum, stomach (separated from it only by the omental bag), the aorta, and the large intra-abdominal vessels (the inferior hollow and left renal veins).

PZhZh consists of three parts:

  1. Heads The head of the pancreas is covered by the duodenum, which forms a horseshoe-like shape around this part of the organ. The head is separated from the body by a groove in which the portal vein is located.
  2. Body. The anterior surface of the gland body is located near the posterior wall of the stomach, the posterior surface is adjacent to the intra-abdominal aorta and lumbar vertebrae. The lower part of the body PZHZH located just below the root of the colon.
  3. The tail. The cone-shaped tail of the organ enters the left hypochondrium and reaches the spleen.

How does the body hurt

The specificity of the pain syndrome depends on the location of the lesion of the gland, its type (diagnosis) and the presence of concomitant or primary pathologies that cause disease of the pancreas.

The defeat of the gland head is accompanied by pain and discomfort “under the spoon” (in the middle part of the abdomen) or right hypochondrium. Despite the predominantly left-sided location of the organ, local inflammation or neoplasm of the head can cause pain on the right. With the defeat of the body, the pain is clearly felt to the left of the midline, and in case of a disease of the tail, to the left of the navel.

Inflammation of the entire gland is manifested by diffuse pain in the upper abdomen.

The nature of the pain and the time of its appearance may be as follows:

  • a sharp cutting or intense aching, independent of food intake (with acute inflammation of the gland),
  • nagging, arising after eating, subsiding when leaning forward (with chronic inflammation, cysts, tumors),
  • aggravated at the end of the meal (when the ducts are blocked and the intraductal pressure increases),
  • any nature of discomfort, accompanied by nocturnal pains (lesion of the duodenum 12, complicated by PZHZH disease),
  • pancreatic colic (with stones in PZHZH).

With the atrophy of the functional tissue of the gland and the progression of the enzymatic failure, the severity of the pain syndrome subsides. Dull aching pain is replaced by a colicky, not having exact localization.

Pain in the area of ​​the gland can be given to many parts of the body: in case of pathologies of the pancreas, the left half of the sternum, the retrosternal and epigastric regions, the left arm and shoulder blade, the loins and even the lower jaw can get sick. In some cases, the pain syndrome is felt immediately in the entire abdominal cavity.

To determine the cause of pain without consulting a doctor and additional research is difficult. Pancreatic pathologies are often mistaken for exacerbation of chronic pathologies of the heart, kidneys, and back, and are not diagnosed in time.

What can be diseases

Pancreas diseases include the following pathologies:

  1. Acute pancreatitis. PJV inflammation is the most common disease of this organ. It is accompanied by pain, diarrhea, a bursting feeling under the ribs, nausea and other symptoms. Pain in acute inflammation is poorly susceptible to antispasmodics and painkillers.
  2. Chronic inflammation of the gland. In a chronic process, pain is less intense and occurs when overeating, drinking alcohol, greasy and iron-irritating foods.
  3. Enzyme deficiency. Enzyme deficiency can be congenital or acquired (for example, in chronic pancreatitis). Pathology is manifested by a change in the color and amount of stool, darkening of the urine, nausea, a feeling of excessive filling of the stomach, weight loss and symptoms of insufficiency of proteins and microelements.
  4. Stones in PZHZH. Calcinates in the tissues of the gland are formed mainly in the case of an alcoholic lesion of the organ, parathyroiditis, and a burdened family history. Burning pains in the upper abdomen, characteristic of this pathology, are accompanied by nausea, vomiting with bile, increased oily feces, increased salivation, etc.
  5. Cysts and fistulas. Liquid formations limited by the capsule may be asymptomatic (with small cyst sizes) or manifest signs of enzymatic deficiency, jaundice, pain in the left hypochondrium and epigastrium, nausea and vomiting (with compression of the duodenum). Fistulas result from spontaneous rupture of a cyst, acute destructive pancreatitis, or bruise of the gland.
  6. Benign neoplasia. Hypertrophy of the adipose, glandular or connective tissue portion of the gland may not manifest any symptoms for a long time. For large benign tumors, jaundice appears, caused by squeezing of the bile ducts, and intestinal obstruction. An increase in the volume of glandular tissues can cause attacks of palpitations, hand tremor and partial paralysis of the limbs.
  7. Cancer of the gland. Malignant diseases are characterized by digestive disorders (loss of appetite, pain in the hypochondrium, discoloration of urine and feces) and general symptoms (weakness, rapid weight loss). With endocrine gland tumors, symptoms of hormonal imbalance appear.
  8. Type 1 diabetes. The autoimmune damage of the beta cells of the islets of Langerhans leads to a decrease in insulin production and the impossibility of glucose consumption by insulin-dependent tissues of the body. Diabetes mellitus is manifested by frequent urination, strong thirst, and increased appetite. In the absence of the introduction of artificial insulin, severe complications arise (diabetic blindness, kidney damage, polyneuropathy, coma).

With the exception of acute pancreatitis (its symptoms in women are less common than in men), diseases of the pancreas syndrome with the same frequency develop in patients of different sexes.

Diagnostics

In the diagnosis of diseases PZHZH apply the following methods:

  1. External examination, patient interview and history taking. The primary diagnosis can be made on the basis of characteristic symptoms (pain in the left hypochondrium and epigastric region, nausea, diarrhea, dark urine) and the results of external examination (yellowness and pallor of the skin, pain when palpating the gland).
  2. Hardware research methods. To determine the size and structure of the components of the gland, as well as to clarify the presence of associated pathologies of the gastrointestinal tract, you can use ultrasound diagnostics, computer and magnetic resonance imaging, X-ray and duodenography, contrast study of ducts (ERCP) and fibroesophagogastroduodenoscopy (FGDS). When a tumor is detected, a biopsy and a histological examination are performed, specifying the degree of malignancy of the neoplasia.
  3. Laboratory diagnosis. Blood tests, urine and feces allow you to set the concentration of glucose, pancreatic enzymes, insulin and total protein (a marker of inflammatory processes in the body).
  4. Load tests. Functional (stress) tests show the quality of food digestion and pancreatic secretory activity. The most common load methods are the secretin-cholecystokinin test, hydrochloric acid test, the Lund test, the study with the introduction of para-aminobenzoic acid and the respiratory test.

Therapy methods

Depending on the diagnosis, treatment of the pancreas may include the following types of drugs:

  • antispasmodics,
  • enzymes
  • agents that reduce the secretion of hydrochloric acid and neutralize its action (antacids),
  • preparations to stimulate and inhibit the function of the gland,
  • decongestants (antihistamines),
  • insulin and others

In acute pancreatitis, inpatient treatment is necessary. To prevent weight loss and dehydration, nutrients and saline are administered intravenously to the patient. Necessary medicines are taken parenterally (in the first 3-4 days) or orally.

Malignant and large benign neoplasms, cysts, fistulas, severe traumatic lesions, some parasitic and inflammatory diseases of the body are indications for surgical intervention.

The role of nutrition in treatment

Diet therapy is an important part of the treatment of inflammation and other diseases of the pancreas. To increase the effectiveness of treatment, you must observe the following rules:

  1. Do not overeat. Calorie daily ration should not significantly exceed the norm corresponding to the age and physical activity of the patient. Daily intake of food should be divided into 5-6 receptions.
  2. Follow the rules of separate feeding. The quantitative ratio of the enzymes produced and the acid-base balance of pancreatic juice depends on the qualitative composition of the food consumed. To facilitate the work of the pancreas, at the time of treatment should go on a separate diet and avoid the simultaneous use of protein and carbohydrate foods.
  3. Abandon foods that negatively affect the pancreas. The recommended diet for the disease PZHZH is the table №5 by Pevzner.

Forbidden foods for diseases of the gland include:

  • jelly, meat and fish broths,
  • any fatty foods (including red fish and high fat meat),
  • canned food
  • marinades, pickles, sauces, spices,
  • smoked meat
  • fried foods
  • some vegetables (tomatoes, radishes, eggplants),
  • ice cream (ice cream),
  • confectionery,
  • sour fruit drinks and juices,
  • alcoholic, carbonated and caffeinated beverages.

Observing a sparing diet in chronic pancreatitis reduces the risk of disease recurrence.

Watch the video: Easing the Pain of Chronic Pancreatitis (January 2020).