Types and classifications of pancreatitis

The most common classification of pancreatitis is based on the results of the II International Medical Symposium held in 1983 in Marseilles.

Although the classification of the disease has undergone minor changes since that time, the system proposed in Marseille proved to be the best and most convenient for modern medics.

Thus, the modern classification of inflammation of the pancreas is based precisely on the basis of the Marseilles classification.

Types of pancreatitis

Pancreatitis or inflammation of the pancreas is characterized by the fact that the pancreatic enzymes produced by the gland are not ejected, as it should normally be, into the duodenum, and, remaining in the pancreas, beginIts digestion.

This situation turns into a painful person for severe pain in the hypochondrium, nausea and vomiting, diarrhea, general deterioration of well-being.

Complications are especially dangerous, among them: hepatic-renal failure, diabetes, pericarditis.

Despite eloquent symptoms of the disease, only the doctor can make an accurate diagnosis, guided by the results of the patient's tests.

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So, patients with suspicion of pancreatitis are necessarily referred for clinical and biochemical blood tests( they help to detect the intensity of the inflammatory process, the level of activity of pancreatic enzymes), urine and feces analysis.

Diagnosis of the disease also involves instrumental studies: ultrasound and radiography of the abdominal cavity, endoscopy, gastroduodenoscopy.

If the results of these studies are diagnosed as "inflammation of the pancreas"( regardless of the form of the disease), then immediately begin treatment, as the loss of time and untimely medical care can cost a person's life.

To date, there are many classifications of the disease, proposed by various scientists.

However, doctors generally use a simplified version, involving the allocation of the following diseases:

• acute inflammation;
• is an obstructive inflammatory process( assuming the presence of stones, expansion of pancreatic ducts, occlusion);
• acute recurrent inflammation followed by recovery;
• non-obstructive chronic inflammation( its functions are performed only partially by the body);
• calcifying variant of chronic pancreatitis( suggests accumulation in the pancreas of salts);
• recurrent pancreatic inflammation of a chronic nature with the appearance of an acute form( damaged tissue is not restored).

Even more simplified Marseilles classification involves the isolation of acute, acute recurrent, chronic pancreatitis, as well as exacerbation of chronic pancreatitis.

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Chronic pancreatitis

Chronic inflammation of the pancreas can be primary and secondary. The latter option is more common and represents an ailment that was the result of other diseases of the digestive tract( stomach and gallbladder).

It is also possible to transition to the chronic form of acute pancreatitis, however this variant is less common.

Often the cause of chronic inflammation of the pancreas is precisely disruptions in the work of the gastrointestinal tract, as well as improper nutrition( spicy, fried, fatty) and bad habits, especially alcoholism.

Despite the existence of a general classification, individual classifications of chronic and acute pancreatitis are often used.

So, the Roman( Marseilles-Roman) classification of chronic pancreatitis is popular.

It involves the allocation of diseases such as:

1. Chronic calcific inflammation of the pancreas is the most common form of chronic pancreatitis. The iron in this case is affected pointwise, and the intensity of the affected areas can be very different. Pancreatic ducts can be hammered and even die. This pathological process often causes a decreased secretion of the protein of lithostatin;
2. Obstructive chronic inflammation. Occurs because of the impassability of the largest pancreatic ducts. This case involves a uniform defeat of the entire pancreas, a modification of its endocrine part. The ailment requires surgical intervention;
3. Chronic fibrous-inducible inflammation of the pancreas, characterized by a strong change in the tissues of the organ;
4. Pancreas fibrosis involves a qualitative change in the main body tissue, tissue necrosis;The inability of the gland to perform its secretory function.

Also, some specialists identify pancreatic cysts and abscesses as separate types of chronic pancreatitis.

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Acute pancreatitis

Acute pancreatic inflammation is manifested by an extremely strong pain syndrome, localized at the top of the abdomen and giving up in the hypochondrium.

The most intense pain a person experiences with this disease after eating. A person after eating also feels sick, strong vomiting is possible with bile and undigested food, diarrhea, increased gas production.

The skin of patients with acute inflammation of the pancreas, as well as their sclera becomes yellowish, the heart rate increases, cyanotic spots can appear on the upper and lower extremities.

Thus, acute inflammation is very different from chronic inflammation and has its own complex classification.

In this classification of acute inflammation of the pancreas can be of two types.

The first of these is used by surgeons and involves determining the form of the disease after surgery.

According to this classification, distinguish between light, moderate and severe pancreatitis.

Accordingly, in the mild form of acute pancreatitis, there are no systemic changes in the work of the organ and its structure.

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The average degree implies the presence of transient organ failure, systemic complications.

Severe form is characterized by persistent organ failure, local systemic complications. In this case, the likelihood of a lethal outcome is very high.

The second type of classification is preferred by therapists, gastroenterologists and other doctors. This classification is more common.

Classification identifies 4 forms of acute inflammation of the pancreas:

1. Otic pancreatitis is the easiest form to treat and does not involve significant changes in the tissues of the pancreas. Characterized by jaundice, tachycardia, pain in the stomach, the presence of PRF( fibrin) in the blood;
2. Limited pancreatic necrosis - characterized by pain in the epigastric region, meteorisms, vomiting, jaundice, tachycardia, fever, in some cases - intestinal obstruction. Analyzes of the patient show hyperglycemia, hypertrypsenemia, low hematocrit. This form is difficult to treat;
3. Diffuse pancreatic necrosis is characterized by the same symptoms as the limited;While its distinctive features are oliguria, gastric bleeding, fever. For this form of pancreatitis are characterized by: hypoxia, trypsemia, severe hyperglycemia, hypocalcemia. The patient's condition deteriorates rapidly and sharply;
4. Total pancreatic necrosis is characterized by a sharp increase in acidity, strong intoxication, loss of sensitivity, shock.

In medicine, the so-called causal classification of acute pancreatitis is also popular.

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So, according to this classification, isolates: food, biliary, gastrogenic, ischemic, infectious, toxic-allergic, congenital and traumatic pancreatitis.

Thus, complex classifications of pancreatitis are quite a lot, because most practicing doctors prefer to use simplified schemes.