CASE OF CHRONIC CALCULOSIS PANCREATITIS IN PATIENT WITH ALCOHOLIC CIRRHOSIS
https://doi.org/10.20514/2226-6704-2018-8-1-66-70
Abstract
The article describes clinical features, differential diagnosis and treatment of chronic calculouse pancreatitis (HCP) with alcoholic liver cirrhosis (LC). Considered etiologic role of chronic alcohol intoxication in the development of these diseases. There was long- term use of alcoholic beverages at hepatotoxic doses and smoking in anamnesis. Patient was examined before entering in our clinic. Сhronic heart failure, nephrotic syndrome, paraneoplastic was excluded as the cause of hydrops. Patient R. was hospitalized in the gastroenterology department with ascites of unknown etiology. The severity of the patient’s condition is caused by malabsorption syndrome and hepatocellular insufficiency leading to the development of edema-ascitic syndrome and trophological failure. In patient there was low of proteins (total protein — 38 g / l), low of albumins (14 g / l). In carrying out endoscopy showed signs of portal hypertension: esophageal varices 1 degree, portal gastropathy; In addition, an increase in the size of the papilla of Vater. To clarify the nature of the defeat of the pancreas held endosonography, in which multiple calcifications are found in the pancreas tissue. To resolve biliary hypertension performed stenting of the common bile duct. Drain the pancreatic duct failed due to the presence of calculus in it at the level of the isthmus. Treatment for our patient should be considered the imposition Ru’s operation. This observation demonstrates social importance of problems of combination HCP with a LC, which lead to reduced quality of life, early disability, reduced life expectancy, as well as to an increase in treatment costs.
About the Authors
A. A. YakushevRussian Federation
Department of Hospital Therapy № 2 of the Faculty of Medicine
Moscow
L. Yu. Ilchenko
Russian Federation
Department of Hospital Therapy № 2 of the Faculty of Medicine
Moscow
I. G. Fedorov
Russian Federation
Department of Hospital Therapy № 2 of the Faculty of Medicine
Department of Gastroenterology
Moscow
S. Yu. Orlov
Russian Federation
Department of Gastroenterology
Moscow
G. G. Totolyan
Russian Federation
Department of Hospital Therapy № 2 of the Faculty of Medicine
Moscow
I. G. Nikitin
Russian Federation
References
1. WHO. Global Status Report on Alcohol and Health. 2011 URL: www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf (дата обращения 10.12.17.)
2. Rehm J., Mathers C., Popova S., et al. Global burden of disease and injury and economic cost attributableto alcohol use and alcohol-use disorders. Lancet. 2009; 373: 2223–2233.
3. Dufour M.C., The epidemiology of alcohol-induced pancreatitis. Pancreas. 2003; 27: 286–290.
4. Maruyama K.M., Incidence of alcoholic pancreatitis in Japanese alcoholics: survey of male sobriety association members in Japan. Pancreas. 2007; 34: 63–65.
5. Löhr J.M., Dominguez-Munoz E., Rosendahl J. et al. HaPanEU/UEG Working Group. United European Gastroenterology evidencebased guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol. J. 2017; 5: 153-199.
6. Луфт В.М., Ткаченко Е.И. Трофологическая недостаточность и критерии ее диагностики. Военный медицинский журнал. 1993; 12: 21-24. Luft V.M., Tkachenco E.I. Trophic failure and it’s diagnostics. Military medical journal. 1993; 12: 21-24 [in Russian].
7. Buchler M.W., Friess H., Uhl W., Malfertheiner P., Chronic pancreatitis: Novel concepts in biology and therapy. A blackwell publishing company. 2002; 614 р.
8. Гаврилина Н.С., Седова Г.А., Косюра С.Д., Трофологическая недостаточность и ее коррекция у пациентов с хроническим панкреатитом. Лечебное дело. 2015; 1:122-128. Gavrilina N.S., Sedova G.A., Kosyra S.D., Malnutrition in patients with chronic pancreatitis. Lechebnoe delo. 2015; 1: 122-128 [in Russian].
9. Сергеева Н.С., Маршутина Н.В. Общие представления о серологических биомаркерах и их месте в онкологии. Практическая онкология. 2011; 4: 141-154. Sergeeva N.S., Marshutina N.V., The place of serological biomarcers in oncology. Practical oncology. 2011; 4: 141-154 [in Russian].
10. Büchler M., Weihe E., Friess H. et al. Changes in peptidergic innervation in chronic pancreatitis. Pancreas. 1992; 7: 183—191.
11. Izbicki J.R., Bloechle C., Knoefel W.T. et al. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial. Ann Surg 1995; 221: 350—356.
12. Будзинский А.А., Лечение панкреатита с помощью внутрипро светных эндоскопических методов. Чрескожные и внутрипро светные эндоскопические вмешательства в хирургии : науч.-практ. конф. с междунар. участием, Москва, 12 ноября. 2010 г. Моск. гос. мед.-стомат. ун-т. С. 55-59. Bydzinskii A.A., The treatment of pancreatitis by dint of endoscopic methods. Transcutaneous and intracavity endoscopics interventions in surgery: sci.-practice conference, Moscow, nowember 12. 2010. Moscow state university of medicine and dentisty. P. 55-59 [in Russian].
13. Третьяк С.И., Ращинская Н.Т., Оценка результатов хирургического лечения билиарных осложнений хронического панкреатита. Мед. журн. 2013; 3: 95–98. Tretyac S.I., Rashinskaya N.T., Results of surgery treatment of biliary complications in patients with chronic pancreatitis. Medical journal. 2013; 3: 95-98 [in Russian].
14. Irving H.M., Samokhvalov A.V. Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis. JOP. J Pancreas (Online) 2009 Jul 6; 10(4): 387-392.
Review
For citations:
Yakushev A.A., Ilchenko L.Yu., Fedorov I.G., Orlov S.Yu., Totolyan G.G., Nikitin I.G. CASE OF CHRONIC CALCULOSIS PANCREATITIS IN PATIENT WITH ALCOHOLIC CIRRHOSIS. The Russian Archives of Internal Medicine. 2018;8(1):66-70. https://doi.org/10.20514/2226-6704-2018-8-1-66-70