MORPHOLOGICAL FEATURES OF EXTRAPANCREATIC LESION OF INTERNAL ORGANS IN ACUTE ENZYMATIC PARAPANCREATITIS

Abstract

The article analyzes the causes of fatal outcomes and structure of postoperative complications in patients who died of acute destructive pancreatitis. The analysis of morphological changes of internal organs has shown that the cause of early fatal outcomes is massive enzymatic noncorrected intoxication, and late lethal outcomes are caused by the intoxication associated with resorbtion of toxic substances from necrotically changed parapancreatic cellular tissue. The special attention is given to the features of anatomic interrelation of the destructively changed pancreas and the affected parapancreatic cellular tissue. An obligate lesion of the parapancreatic cellular tissue was found in the necrosis centres in the pancreas parenchyma. The article studies morphological changes in the wall of the small intestine that cause enteral insufficiency in acute destructive pancreatitis. It was shown that according to the autopsy data, the real number of observations of total pancreatonecrosis was not adequate if to compare with that that was supposed according to the data of clinical and intraoperative inspections. The analysis of operative interventions showed that purulent-necrotizing parapancreatitis is an object of surgical intervention.