胰腺疾病(英文)资料.pptVIP

胰腺疾病; 解剖生理概要;c;Pathology acute edematous pancreatitis acute hemorrhagic necrotizing pancreatitis (acute hemorrhagic pancreatitis, acute necrotizing pancreatitis);Pathophysiology Hypersecretion and obstruction Self-enzymatic digestion Enhancement of Vessel permibility Cytokine，infection Decreased arterial perfusion Edematous hemorrhagic necrotizing ;Clinical finding Abdominal pain Abdominal distention Nausea and vomiting Peritonitis Other: Respiratory failure, confusion, or coma. Low-grade to moderate fever Tachycardia and hypotension and Shock Mild jaundice, Pleural effusion. ;急性胰腺炎;Laboratory finding Amylase and lipase (elevations of amylase are more sensitive but less specific than lipase in the diagnosis of acute pancreatitis ) 500 400 300 200 100 0 0 1H 24H 48H 5DAY ;急性胰腺炎;Imaging finding X-ray Dilated loop of small bowel (sentinel loop) Abrupt cessation of gas in the distal transverse colon (colon cutoff sign) Radioopaque densities (biliary calculi) Left-sided pleural effusion B-US: pancreatic edema, ascites---- CT: Important;?CT is the best diagnostic test for the diagnosis of acute pancreatitis. ?Contrast-enhanced CT is excellent for diagnosis of pancreatic necrosis;急性胰腺炎;急性胰腺炎;急性胰腺炎;Diagnosis and differential Diagnosis Acute edematous pancreatitis and acute hemorrhagic necrotizing pancreatitis Other diseases Acute appendtitis Ileus Perforated gastroduodenal ulcer Biliary disease Ruptured hepatoma;急性胰腺炎;Agents to inhibit pancreatic secretion Have not been found to be useful in altering the course in acute pancreatitis Somatostatin(sandostatin stilamin) Protease inhibitors (trasylol抑肽酶) Surgical therapy Inefficiency by internal medicine Complication (pancreatic or/and peripancreatic Infection and abscess) Combined with biliary diseases(Gallstone ASP) ; Surgical approach Resection of necrotic tissue