Factores de riesgo, diagnóstico y complicaciones de la pancreatitis crónica, estudio a realizar en pacientes del Hospital Teodoro Maldonado Carbo, período 2012-2015
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La pancreatitis crónica es la inflamación de la glándula pancreática que ocasiona una destrucción progresiva del parénquima e irreversible afectando su doble función secretora: exocrina encargada de la secreción del jugo pancreático y la endocrina responsable de la liberación de diversas hormonas al torrente sanguíneo, afecta más a hombres que mujeres en relación de 3/1. La mayoría de los casos (80%) se presenta con brotes de pancreatitis aguda.
La etiología de la Pancreatitis Crónica es multifactorial se denomina con el acrónimo TIGARO (toxico- idiopático-genético-autoinmune- recurrente y obstructivo) en Ecuador se estima que un 47 % de la población tiene problemas de alcohol, de los cuales un 57% son jóvenes. Con lo cual corrobora que la etiología primaria es el abuso del alcohol (toxico).
El diagnóstico es clínico se manifiesta por dolor abdominal, esteatorrea, diarrea, pérdida de peso, además de pruebas función pancreática; y exploraciones radiológicas como: ecografía, radiografía de abdomen, tomografía computarizadas y resonancia magnética, de las cuales la de mayor utilidad es la Colangiopancreatografía retrograda endoscópica y la colangiorresonancia magnética
Las complicaciones más frecuentes incluyen pseudoquistes pancreáticos, hemorragias, fistulas pancreáticas, cáncer de páncreas y la estenosis del colédoco intrehepatico con ictericia obstructiva secundaria.
Tratamiento se base en dieta nutrición y antioxidantes, adicionalmente tratamiento para el dolor como analgésicos, tratamiento a base de enzimas pancreáticas como Octreotida que son tratamientos no invasivos y por ultimo tratamiento quirúrgico para descomprimir el conducto pancreático y el intersticio o eliminar el tejido afectado que produce dolor.
Chronic pancreatitis is inflammation of the pancreatic gland that causes progressive parenchymal and irreversible destruction affecting its dual secretory function: exocrine responsible for the secretion of pancreatic juice and endocrine responsible for the release of various hormones into the bloodstream, affects more men than women in ratio 3/1. Most cases (80%) occurs with bouts of acute pancreatitis. The etiology of chronic pancreatitis is multifactorial is called by the acronym TIGARO (toxicological-genetic-idiopathic recurrent and Obstructive autoinmune-) in Ecuador is estimated that 47% of the population has problems with alcohol, of which 57% are young. Thus it confirms that the primary etiology is alcohol abuse (toxic). Diagnosis is clinical manifested by abdominal pain, steatorrhea, diarrhea, weight loss, plus pancreatic function tests; and radiological examinations such as ultrasound, abdominal X-ray, CT scan and MRI, which is the most useful endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography The most common complications include pancreatic pseudocysts, hemorrhage, pancreatic fistulas, pancreatic cancer and bile duct stenosis intrehepatico with secondary obstructive jaundice. Treatment is based on diet nutrition and antioxidants, further treatment for pain as analgesics, treatment based on pancreatic enzymes such as Octreotide noninvasive treatments and finally surgery to decompress the pancreatic duct and the gap or remove the affected tissue that produces pain.
Chronic pancreatitis is inflammation of the pancreatic gland that causes progressive parenchymal and irreversible destruction affecting its dual secretory function: exocrine responsible for the secretion of pancreatic juice and endocrine responsible for the release of various hormones into the bloodstream, affects more men than women in ratio 3/1. Most cases (80%) occurs with bouts of acute pancreatitis. The etiology of chronic pancreatitis is multifactorial is called by the acronym TIGARO (toxicological-genetic-idiopathic recurrent and Obstructive autoinmune-) in Ecuador is estimated that 47% of the population has problems with alcohol, of which 57% are young. Thus it confirms that the primary etiology is alcohol abuse (toxic). Diagnosis is clinical manifested by abdominal pain, steatorrhea, diarrhea, weight loss, plus pancreatic function tests; and radiological examinations such as ultrasound, abdominal X-ray, CT scan and MRI, which is the most useful endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography The most common complications include pancreatic pseudocysts, hemorrhage, pancreatic fistulas, pancreatic cancer and bile duct stenosis intrehepatico with secondary obstructive jaundice. Treatment is based on diet nutrition and antioxidants, further treatment for pain as analgesics, treatment based on pancreatic enzymes such as Octreotide noninvasive treatments and finally surgery to decompress the pancreatic duct and the gap or remove the affected tissue that produces pain.
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Pancreatitis, Diagnóstico clínico, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Tratamiento, Factores de riesgo