Pancreatic insufficiency

Introduction The pancreas is divided into two parts: the exocrine gland and the endocrine gland. The exocrine gland is composed of acinar and glandular ducts, and the acinus secretes pancreatic juice. The glandular duct is the channel through which pancreatic juice is discharged. The pancreatic juice contains sodium hydrogencarbonate, trypsin, lipase, amylase and the like. Pancreatic juice is discharged into the duodenum through the pancreatic duct and has the function of digesting protein, fat and sugar. The endocrine glands are composed of cell clusters of different sizes, the islets, which secrete insulin and regulate sugar metabolism.

Cause

Causes of pancreatic insufficiency:

1. Source of infection: The only source of infection that rumors return to heat is the patient; the main source of infection for rumor returning to heat is rodents, and patients can also be sources of infection.

2. Ways of transmission: The spread of rumors of returning to the heat is based on body and head lice. It is rumored that the media of returning to the heat are different kinds of soft palate. You can carry a spiral body for life. It can be passed on by eggs. Therefore, it is not only a medium of communication, but also a storage host for pathogens.

3. Susceptible people: both men, women and children are susceptible. Immunity does not last after the illness. There is no cross-immunization between the two types of regression heat.

an examination

Related inspection

Serum chymotrypsin glycolipid tumor marker detection of cancer antigen 19-9 (CA19-9) Lund test pancreatic tumor marker (CA 19-9)

Pancreatic exocrine function test: The pancreatic exocrine function test is a method for testing pancreatic function.

Visual examination: the abdomen is flat, but hemorrhagic necrotizing pancreatitis can cause abdominal distension due to intestinal paralysis, and when there is a pancreatic cyst or abscess, there may be localized bulging.

Palpation: tenderness, rebound tenderness and muscle tension can vary depending on the extent and location of the lesion. Under normal circumstances, there is a degree of tenderness in the upper abdomen, but the tenderness is related to the lesion. The lesion is in the head of the pancreas, the tenderness is in the right upper abdomen; the lesion is in the tail of the pancreas, and the tenderness is in the left upper abdomen; the lesion affects the entire pancreas, and there is tenderness in the upper abdomen. If hemorrhagic necrotizing pancreatitis, abdominal peritoneal fluid for a long time, often full abdominal tenderness, rebound tenderness and muscle tension.

Percussion: When there is flatulence, the percussion is drum sound. If there is exudation in the abdominal cavity, the percussion is voiced and the mobile voiced sound can be measured.

Auscultation: The bowel sounds are weakened. When there is intestinal paralysis, it can be "quiet belly".

Serum, urine or abdominal puncture

Differential diagnosis

Symptoms of confusing pancreatic function :

Pancreatic insufficiency and neutrality in children are mainly due to dysplasia of the pancreas, mainly due to poor development of exocrine tissue, which is characterized by sparse acinar cells, normal islet development, total amount of pancreatic secretion, and normal HC03 content. At the same time, accompanied by dysplasia of the myeloid cell line, occasionally lack of megakaryocytes, may have dysplasia of the skeletal metaphysis, and focal calcification in the ankle. When the disease is complicated by pulmonary infection, it is easily confused with cystic fibrosis of the pancreas. Should also pay attention to the identification of acute pancreatic, chronic pancreatitis.

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