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Pancreas with atherosclerosis and myocardial infarction
Last reviewed: 18.10.2021
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Pancreatic lesions in atherosclerosis and myocardial infarction
Causes, pathogenesis. The defeat of the pancreas in atherosclerosis is observed mainly in people older than 60 years, less often and at a younger age - mostly among people with alcoholism. In this case, sclerotic changes develop in the pancreas, its excretory and endocrine functions are violated. Violation of the latter is a common cause of so-called senile diabetes. However, there is an opinion in the literature that vascular lesions of the pancreas relatively rarely cause effects such as inflammatory changes, since it has a well developed network of collaterals.
In contrast to this opinion, some scientists and clinicians believe that the pancreas is very sensitive to circulatory disturbances in it, despite a well-developed vasculature. However, blockage of one or more vessels causes only focal ischemic and necrotic changes, and not a picture of diffuse pancreatic necrosis. Quite often there are hemorrhages in the type of diapedesis - with a heavy flu, a number of infectious diseases, allergic reactions, accidental overdose of anticoagulants, etc.
Pancreatic lesions are observed in acute myocardial infarction: in mild cases they have a functional character and manifest only mildly expressed pain in the left hypochondrium and impairment of the excretory and endocrine functions of the pancreas; less infarction of the myocardium accompanied by acute (in some cases, hemorrhagic) pancreatitis, in some cases there is an acute thrombosis of pancreatic vessels with a clinical picture of acute hemorrhagic pancreatitis.
The development of acute hemorrhagic pancreatitis can also lead to compression of the celiac artery, vasculitis and, possibly, severe episodes of arterial hypotension.
Symptoms, diagnosis. It is difficult to establish the correct diagnosis for various circulatory disorders in the pancreas, and perhaps, in the main, only presumably: if, against the background of diseases in which there are circulatory disorders in the pancreas, suddenly, without special reasons, acute pancreatitis occurs or diabetes is gradually formed. The diagnosis is confirmed by ultrasound of the pancreas and the study of the activity of its enzymes in the blood and urine, and if the patient's condition allows - and in duodenal contents.
Treatment. In the first hours and days - treatment with acute pancreatitis and diabetes. It is also necessary to treat the main process (heart failure, atherosclerosis, etc.). Subsequently, with a favorable outcome, as a rule, functional pancreatic insufficiency and chronic pancreatitis are formed. Treatment for exocrine insufficiency of the pancreas is carried out by diet (as in chronic pancreatitis), frequent fractional meals and preparations of pancreatic enzymes (panzinorm, pancitrat, festal, pancreatin, etc.) at the required dose.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]