Fading around the navel

Introduction Fading around the umbilicus is one of the signs of acute hemorrhagic necrotic pancreatitis. Acute hemorrhagic necrotic pancreatitis is a type of acute pancreatitis that is caused by the continued development of acute edematous pancreatitis. Pancreatic acinar, fat, large blood vessels necrosis, pancreatic tissue edema, volume increase, extensive hemorrhage and necrosis. A large amount of bloody exudate in the retroperitoneal space. The omentum and mesangial tissue are digested by the exuded trypsin. This type of pancreatitis is a serious condition with rapid development, many complications, and high mortality.

Cause

The etiology of this disease is related to the following factors: biliary tract disease, which is the most common cause in China, accounting for 10% of pancreatic duct infarction, obstruction of pancreatic duct due to aphid edema, tumor or sputum, etc.; refers to adjacent lesions of intestinal nipple; alcoholism and binge drinking Gluttony is the main cause of Western countries; surgery and injury; other hypercalcemia and hyperparathyroidism can induce acute pancreatitis, some infectious diseases such as mumps viral hepatitis may be associated with pancreatitis.

an examination

Related inspection

Abdominal plain film abdominal vascular murmur

Symptom

Severe upper abdominal pain or hyperthermia during the treatment of acute edematous pancreatitis, diffuse peritonitis, paralytic ileus, upper abdominal mass, gastrointestinal bleeding, neuropsychiatric symptoms, shock.

2. Signs

Abdominal bulging, tenderness and rebound tenderness, mobile dullness, bowel sounds disappeared, a small number of patients due to bloody exudate containing pancreatic enzyme infiltrated into the subcutaneous space through the retroperitoneal space, subcutaneous fat necrosis, bilateral abdominal wall ecchymoses and umbilicus fade.

3. Auxiliary inspection

1 hematuria amylase may have a sustained increase or not due to extensive necrosis of the pancreas. Blood calcium is reduced, and its value is positive for hemoglobin.

2 abdominal puncture fluid opacity, amylase, lipase increased. Ultrasound examination of type 3B showed pancreatic enlargement and rare reflection of internal light spots. CT showed diffuse enlargement of the pancreas, irregular shape, blurred edges, and widening of the peripancreatic space.

Differential diagnosis

Must be differentiated from acute gastroenteritis, acute perforation of ulcer disease, acute cholecystitis of cholelithiasis, myocardial infarction, acute intestinal obstruction, ischemic embolization of mesenteric vessels.

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