13. Mesenchymal inflammatory syndrome

Mesenchymal inflammatory syndrome is a consequence of sensitization of immunocompetent cells and activation of the reticuloendotemial system in response to antigenic stimulation, is a complex biological response of an adaptive nature, aimed at eliminating the corresponding pathogenic effects.

REASONS: acute and active chronic liver diseases, connective tissue diseases, sepsis.

SYMPTOMS:

1. Pain in the upper abdomen, right hypochondrium;

2. An increase in the liver, jaundice;

3. Splenomegaly;

4. fever;

5. Leukocytosis (or leukopenia), eosinophilia, accelerated ESR;

6. Increase in the level of a2 - and gamma globulins in blood serum;

7. Change in protein-sedimentary samples (thymol, sublimate, etc.);

8. Increased levels of IgG, IgM, IgA, the appearance of nonspecific antibodies to DNA, mitochondria, smooth muscle fibers;

72

9. Polyarthralgia, vasculitis of the skin, kidneys, lungs.

4.3 SYNDROMES IN PREVENTION OF THE PANCREAS

1. Pancreatic pain syndrome

CAUSES:

1. sprain of the pancreatic capsule

2. increased pressure in the ducts (obstruction and stenosis)

3. irritation of the parietal sheet of the peritoneum covering the pancreas.

SYMPTOMS:

1. Pain in the epigastric region, radiating to the left hypochondrium, to the back, to the interscapular space, to the left shoulder blade, less often to the right hypochondrium / as with biliary colic /:

- constant without rhythm, without typical dependencies

- accompanied by nausea and vomiting in acute pancreatitis / necrosis /:

- often accompanied by collapse, can cause shock, lasts continuously for several days with chronic pancreatitis:

- moderate pain for several hours with pancreatic cancer:

- constant, progressive, forcing the patient to take a relieving position with an inclined anteriorly with cancer of the head of the pancreas:

- Often subhepatic jaundice syndrome.

On palpation of the abdomen, the following painful zones and points are determined:

• Shoffar zone - the area of projection of the head of the pancreas.

• Hubergrits-Skulsky zone - similar to the Shoffar zone, but located on the left. Soreness in this zone is characteristic for the localization of inflammation in the body area of the pancreas;

• Desjardins point - located 5-6 cm above the navel along the line connecting the navel to the right armpit.

Soreness at this point is characteristic for the localization of inflammation in the head of the pancreas;

• Hubergritsa (Kacha) point - similar to Desjardins point, but located on the left. Soreness at this point is observed with inflammation of the tail of the pancreas;

• Mayo-Robson point - located on the border of the outer and middle third of the line connecting the navel and the middle of the left costal arch. Soreness at this point is characteristic for inflammation of the tail of the pancreas;

• region of the rib-vertebral angle on the left - with inflammation of the body and tail of the pancreas.

• left-side phrenicus symptom - pain when pressed between the legs of the sternocleidomastoid muscle at the attachment to the medial edge of the clavicle.

73

Pic 4.6 Pancreatic pain zones