AKHILIYA PANCREATIC — (achylia pancreatica; grech, and - otritsa. + chylos juice; lat. pancreaticus relating to a pancreas) — the lack of enzymes in pancreatic juice caused by insufficiency of vneshnesekretorny function of a pancreas.
Most of researchers considers that And. the item is result of organic lesions of a pancreas: hron, the pancreatitis which is followed by diffuse, profound change of body and an atrophy of ferruterous fabric with preferential disturbance of external secretion; tumors of a pancreas; obstruction of a pancreatic channel stone; states after a pancreatectomy. About And. items of functional character speak when at an objective research do not find signs of organic lesion of body. Functional insufficiency of a pancreas can be observed at some endocrine diseases (a craw diffusion toxic, an addisonova a disease, diabetes), avitaminosis (to a spr, a pellagra), diseases of a liver and bilious ways, a nutritional dystrophy, infectious diseases. Functional changes can be short-term or long.
Clinical picture it is shown by the dispeptic phenomena (small appetite, nausea, an eructation, abdominal distention, uncertain abdominal complaints and, especially, persistent ponosa), existence of the voluminous light-painted fatty excrements. The progressing weight loss and exhaustion of the patient is often observed. Jaundice is absent.
Diagnosis it is put on the basis of a clinical picture and laboratory definition of pancreatic enzymes in duodenal contents, blood, urine and Calais.
Pancreatic enzymes — trypsin, a lipase, amylase — define in the duodenal contents received at duodenal sounding (see) later uses of any activator of secretion of a pancreas. Most the irritation salt to - that comes nearer to fiziol, to conditions. Content of trypsin in duodenal juice is determined at the alkalescent reaction blocking effect of pepsin which can get with gastric contents. In urine along with amylase investigate also the content of trypsin. The research of trypsin in blood was not widely adopted owing to difficulty of its definition. The research of content of pancreatic enzymes in Calais is conducted seldom. As lack of pancreatic enzymes leads to disturbance of process of absorption, it is possible to judge availability of enzymes and indirectly according to a proteopepsis, fats and carbohydrates. Especially importance for diagnosis And. the item has establishment steatorrheas (see). A simple and reliable research for identification of a steatorrhea is the tracer technique by means of marked lipids (see Absorption, a radio isotope research).
At total organic lesion of gland and as consider, at functional disturbances, during the fading of function of all pancreas enzymes are absent in pancreatic juice, blood and urine. At the pancreatic insufficiency caused by obstruction of a pancreatic channel lack of enzymes in pancreatic juice and Calais, increase in their content in blood and urine is characteristic: at the termination of intake of enzymes in a duodenum they are soaked up in blood, accumulation them in blood leads to the increased allocation them with urine.
Forecast depends on character And. item. At functional forms it is favorable. At And. the item, connected with organic lesion of bodies, the forecast depends on a current of a basic disease.
Treatment it has to be directed to a basic disease. The known benefit is brought by restriction in food of fats and proteins, administration of these feedstuffs in easily assimilable look, and also intake divorced salt to - you, Pancreatinum (on 1 g 4 times a day before meal).
Bibliography: Zakrzhevsky E. B. Functional diagnosis of diseases of a pancreas, page 100, etc., JI., 1961; Leporsky N. I. Diseases of a pancreas, page 110, M., 1951; Mazhdrakov G. M. Diseases of a pancreas, the lane with bolg., page 99, 180, Sofia, 1962; Shelagurova. A. Diseases of a pancreas, page 44, M., 1970.
A. I. Ishmukhametov, G. N. Karapetyan.