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Khirurgii

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Year 2010 Vol. 18 No 5

GENERAL AND SPECIAL SURGERY

MAYOROV V.M., DUNDAROV Z.A., PODOLSKY A.L.

MORPHOLOGICAL CHANGES OF THE INTERNAL ORGANS AT ACUTE NECROTIZING PANCREATITIS ACCORDING TO AUTOPSY DATA

Objectives. To analyze the causes of lethality outcomes, to reveal the regularities of the pathological changes in the internal organs and to determine the peculiarities of multi-organ failure development at acute destructive pancreatitis ADP).
Methods. The continuum retrospective analysis of 132 autopsied patients died of ADP was carried out during the investigation. Vivo diagnosis of the disease was based on the analysis of clinical and laboratory data and the results of the complex instrumental examination. Verification of the infection in the pancreatic necrosis zones and fluid accumulation was based on the bacteriological examination of the materials obtained by the puncture under the sonographic control or intraoperatively.
Results. The chief cause of the lethal outcome was a complicated ADP, which was diagnosed in 98, 64 % of the dead. Early lethal outcomes are caused by the development of a severe enzymatic uncorrected endotoxemia resistant to the applied methods of detoxification.
Conclusions. Lethal outcomes in the early phase of pancreatic necrosis development are linked with the massive intoxication of the enzymatic origin. Late complications manifest at the stage of melting of the destructively changed pancreas and the surrounding parapancreatic fiber.

Keywords: acute necrotizing pancreatitis, parapancreatitis, morphological changes, autopsy
p. 28 – 36 of the original issue
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