What is diffuse pancreatic changes?

Having received an ultrasound with the phrase "diffuse changes in the pancreatic parenchyma," adults try to find out for themselves what kind of disease and how it can be treated. It is important to avoid such erroneous actions for several reasons.

First, the conclusion of a doctor from the ultrasound diagnosis room means not a diagnosis, but a description of the result of using the hardware study. It complements other available tests, clinical symptoms, and is used by the attending physician in a complex to assess the state of digestion, and to find the cause of the disorders.

Secondly, the detected changes are also characteristic for the pathology of other organs. Third, not always diffuse changes in the pancreas( DIP) are required to be treated. Medical terms are difficult to perceive by non-professionals. Let's look at the frightening concepts.

What is the "diffusion" process in the pancreas

In translation from Latin, the diffusion process is a propagating change from one site to the entire organ or tissue. At the same time, the correct structure of the structures collapses, the blood vessels and blood flow change, and some of the cells can cease functioning.

From histology it is known that up to 90% of pancreatic tissue occupies its exocrine part, consisting of lobules. Inside each lobule are the acini that produce pancreatic juice.

Secret is collected in small ducts( in the center of the acini), then merges into the main duct and is sent to the duodenum

. With the help of ultrasound, the anatomical structure of the parenchyma is structured only when the healthy cells are replaced by denser ones. Diagnosis is based on the possibility of reflection or absorption of a sound wave. Each tissue has its own echogenicity. Normally, the pancreas is released as a uniformly dark formation lying in the retroperitoneal zone. The density of the parenchyma does not differ from the liver, it is considered hypo- and anechogenous.

When the appearance of any changes in the body, seals on the monitor of the ultrasound device, echoes of a lighter shade( hyperechoicness) are seen. According to them, the doctor-specialist identifies the most typical picture of focal( only in a certain zone) or diffuse nature.

What kinds of violations are caused by diffuse changes?

Diffuse changes in the pancreas reflect the formed hyperechoic tissue structures, but do not indicate a variant of the pathological process that caused them. The most common types of disorders are related to:

• with dystrophy;
• inflammation and swelling( with pancreatitis);
• substitution of healthy acini with fatty inclusions as steatosis;
• fibrosing of the parenchyma( proliferation of scar connective tissue).

With the help of echoes of diffuse pancreatic changes, it becomes possible to establish the degree of development of pathology, to reveal the proportion of remaining intact tissue. This is important for choosing the best treatment tactics in a particular case.

In the parenchyma, a lighter duct passes, the graininess of the pattern is similar to the

lipomatosis. What are the causes of

? Diffuse parenchymal changes may be accompanied by an increase or decrease in the size of the organ. With swelling, the tissues swell and promote the growth of the gland mass. Dystrophic disorders, fibrosing reduce the size, wrinkle the shape.

The most common echographic features are:

• in general metabolic-dystrophic processes in old age;
• impaired blood circulation in the pancreas;
• endocrine diseases and metabolic syndromes;
• changes in the functioning of the liver, bile ducts.

In the elderly, patients with diabetes on an ultrasound scan of the gland looks normal or reduced in volume. Parenchymal changes in the pancreas are caused by the replacement of healthy tissue with fat. As a result, echogenicity increases. In such cases, it is necessary to decide the need for treatment in view of the existing violations.

In acute pancreatitis with severe inflammation symptoms, diffuse changes in the parenchyma are considered as an indication of the severe course of the disease, a high risk of complications. Edema and internal circulation in the body cause an increase in size with increased echogenicity.

Chronic pancreatitis is accompanied by a gradual destruction of the gland tissue, replacement of scars, wrinkling of the form. The manifestation of dense echogenic structures indicates the degree of loss of functional fullness of the organ. A similar picture is given by diabetes mellitus with violation of the endocrine activity of the pancreas.

The causes of diffuse abnormalities of echogenic properties are those that contribute to the listed diseases:

• nutritional deficiencies( excessive consumption of fatty, spicy, fried or canned food, sweets, confectionery or starvation);
• frequent stressful situations;
• chronic alcoholism, nicotine dependence, drug poisoning;
• dysfunction of the digestive system;
• negative effect of medicines;
• weighed down by heredity.

How does the doctor diagnose the degree of disturbances in the ultrasound examination?

To assess the signs of diffuse changes in the pancreas, the medical specialist uses the comparative shades of the color of the study area, the visibility of the vessels and the common duct, and the size of the organ. When localizing light areas in a particular zone( focal shadows), a preliminary conclusion is made about the most probable formation and its place is indicated.

The degree of impairment is assessed as:

• insignificant - with compensated diabetes mellitus, dystrophic processes in patients of senile age with circulatory failure, during periods of stress, depressions;
• moderate - with chronic pancreatitis, lipomatosis, impaired digestion;
• expressed - with stagnation of pancreatic juice, swelling of the parenchyma during acute pancreatitis.

ultrasound allows to determine the size of the splenic vein diameter( splenic vein is indicated), the extension confirms portal hypertension

. In addition, the conclusion is usually uniform or uneven distribution of the changes. The unevenness of diffuse echographic changes in the structure of the pancreas is revealed in sclerosing, cystic lesions, and the tumor process in the parenchyma.

A uniform granular pattern is determined in acute pancreatitis, covering the entire organ with inflammation. The detection of a common process in diabetes mellitus indicates the addition to the endocrine pathology of inflammatory or fibrotic causes of decreased pancreatic function. In such cases, the problem is not how to treat diffuse changes, but in creating the most possible conditions for maintaining and supporting the functioning of the organ.

Symptoms of

Any manifestations of pathology of the pancreas the doctor finds out by questioning the patient, examining, comparing with the results of blood tests, urine, feces, biochemical tests.

Ultrasound results are a valuable diagnostic tool. However, they are not associated with specific symptoms and complaints of the patient.

In acute pancreatitis, the strongest pain of shingles with nausea, vomiting, signs of a shock condition( pallor, tachycardia, falling of arterial pressure) comes to the fore in the first place. The patient needs intensive therapy to prevent necrosis( necrosis) of the parenchyma and diffuse peritonitis caused by the release of enzymes into the abdominal cavity.

In the chronic course of pain, there are only if the exacerbation or violation of diet. More worried about loss of appetite, weight loss, frequent diarrhea, bloating. Digestion is disrupted as the tissue is replaced with fibroids, and there is an increasing demand for medicines.

Fibrogenation of the parenchyma in a chronic process necessarily captures the endocrine gland and suppresses the production of insulin. Diabetes mellitus in this patient is difficult, because it depends on the irreversible process. Symptoms include: vomiting, weight loss, thirst, diarrhea.

Diabetes mellitus is accompanied by diffuse changes

Substitution of normal cells with fat( lipomatosis) also leads to disruption of the gland functions. The severity of the manifestations is related to the degree of organ damage, compression of the main duct and endocrine tissue.

In case of a dystrophic process or fatty infiltration, a person may not know for a long time about the disruption of the functioning of the pancreas. The pains are fickle and mild, they are explained by other reasons. Pathology is detected only on ultrasound.

What variants of echogenicity change indicate the stage of the disease?

On the violation of tissue density for ultrasonic waves, the connection with other signs can be guided in the degree of pathological disorders in the pancreas. The main diagnostic options:

• decrease in parenchyma density( reduced echogenicity) + body size growth → pancreatic juice outflow is difficult, enzymes enter the blood, is characteristic of acute pancreatitis;
• is the same if the norm is preserved in size → typical for chronic pancreatitis, duct duct crinkle;
• general increase in echogenicity, with normal size of the gland is a sign of the onset of fat tissue replacement, accompanies diabetes mellitus, obesity, dystrophy in the elderly;
• increased parenchyma density + increased echogenicity, but organ size decreased or normal → signs of fibrosis during recovery from inflammation, metabolic disorders.

What is meant by "diffuse changes in the tail of the pancreas"?

Anatomical parts of the pancreas are divided into body, head and tail. The latter is located on the left, next to the spleen. Here begins the excretory duct, which collects the secret from the whole organ and passes through the main part. The width of the tail is not more than 30 mm.

With a diffuse change in the tail, the zone expands and contracts. In diagnosis, this sign is important for detecting impaired patency of the splenic vein. It is often associated with portal hypertension.

Diffuse tail changes detect ¼ of all pancreas research

Causes of diffuse reactive changes

Pancreatic response occurs in response to various diseases of the digestive system. In this case, they are manifested in ultrasound in the parenchyma diffusely. The most secreting function of the gland changes depending on the activity of the liver, the bile secretion system. Patients with cholecystitis, cholelithiasis, hepatitis may develop secondary pancreatitis.

A violent reaction develops with symptoms of poisoning with drugs, industrial and household poisons. In the same way, there are changes in the pancreas in a child, with increased sensitivity or negative effects of medication.

In childhood, unexplained enzyme deficiency, anomalies in the development of bile ducts play a role. With ultrasound, signs similar to acute pancreatitis are revealed. The peculiarity is the more frequent localization of changes in the tail zone of the gland, the expansion of the duct.

Ultrasound of the pancreas is included in the complex examination of the abdominal cavity

Assistance to the patient

If an ultrasound is detected for the first time, the patient must undergo a complete examination to establish the cause. It includes mandatory blood tests, which allow you to judge pancreatitis, the functions of the pancreas. Concurrent studies of liver tests, amylases, and urine diastases are important. With an increase in glucose levels in the blood and urine will need to clarify the type of diabetes.

Treatment of diffuse changes in the pancreas of the dystrophic type is not carried out, because the changes are not threatening. With any kind of defeat, patients are recommended to follow a strict diet( with an inflammation of 1-2 days of hunger and thirst) according to the table number 5p with a gradual transition to a constant table number 5.

The inflammatory process is treated with high doses of antibiotics and corticosteroids. In case of toxic shock, the patient needs to remove the products of the decay of the gland from the body, support the activity of the heart. To temporarily block the production of enzymes, artificial means such as Creon, Panzinorma are used.

In connection with significant hypovitaminosis, vitamins are given in injections, pro and prebiotics to restore intestinal function. Simultaneous damage to the liver and gallbladder requires the use of hepatoprotectors, cholagogue. Some diseases are treated only surgically.

Diffuse pancreatic changes revealed on ultrasound help to assess the overall pathological process of the digestive system. After the examination, it is necessary to consult an experienced gastroenterologist. It may be necessary to consult an endocrinologist. The main thing is not to miss the time until you can restore the gland function.