Article 13321

Title of the article

Ways to optimize postmortal diagnostics of acute destructive pancreatitis 

Authors

Al'fiya K. Imaeva, Candidate of medical sciences, associate professor, head of the sub-department of histology, Bashkir State Medical University (3 Lenina street, Ufa, Russia), E-mail: Alfiya.Imaeva@mail.ru
Tagir I. Mustafin, Doctor of medical sciences, professor, head of the sub-department of pathological anatomy, Bashkir State Medical University (3 Lenina, Ufa, Russia), E-mail: kaf-pa@bashgmu.ru 

Index UDK

616-091.5 

DOI

10.21685/2072-3032-2021-3-13 

Abstract

Background. The purpose of the research is to improve the pathological diagnosis of acute destructive pancreatitis. Materials and methods. To solve the purpose, we have developed new tactical and technical methods of pathological examination of a corpse in acute destructive pancreatitis. Before the autopsy, a thorough study of the medical documentation is carried out, and the autopsy itself involves the study of organopathology, including at the light-optical level. This is necessary for understanding the mechanisms of thanatogenesis and establishing the immediate cause of the patient’s death. The autopsy technique is fraught with certain difficulties, since many of the subjects underwent surgical interventions during their lifetime. In this case, the pathological process covers the near and distant tissue structures. For a pathologist, it is important to understand the sequence of inclusion of other internal organs in the purulent-necrotic process. Results. The results of postmortem examination are presented. The main tactical and technical aspects were worked out on 65 corpses. In acute destructive pancreatitis, the introduction of a contrast agent into the duct system of the pancreas gives an idea of the ways in which the purulentnecrotic process spreads along the retroperitoneal tissue and other anatomical structures. The use of the device developed by the authors makes it possible to more accurately bring the contrast agent to the epicenter of the pathologically altered cellular structures of the retroperitoneal space, to predetermine the volume of the lesion and the pathway of fluid outflow. The variants of the dissemination of the purulent-necrotic process were studied, on the basis of which the types of acute destructive pancreatitis were proposed. Conclusion. The developed set of tactical and technical methods of pathological anatomical examination during the section of organs allows one to arrive at a qualitative clinical and anatomical analysis of the case in acute destructive pancreatitis. 

Key words

acute destructive pancreatitis, postmortem examination, new techniques 

Download PDF
References

1. Avakimyan S.V., Avakimyan V.A., Didigov M.T., Babenko E.S. The choice of the method of treatment of acute pancreatitis, depending on the prognosis of the course of the disease. Vestnik khirurgii imeni I.I. Grekova =Bulletin of surgery named after I. I. Grekov. 2016;175(1):37–41. (In Russ.)
2. Firsova V.G., Parshikov V.V., Kuznetsov S.S., Bugrova M.L., Yakovleva E.I. Acute pancreatitis: morphological aspects of the course of the disease. Annaly khirurgicheskoy gepatologii = Annals of surgical hepatology. 2016;19(1):86–95. (In Russ.)
3. Zatevakhin I.I., Sitsishvilli M.M. Assessment of organ and extraorgan lesions in acute destructive pancreatitis and its effect on mortality. Annaly khirurgii = Annals of surgery. 2003;(1):35–42. (In Russ.)
4. Kudelich O.A., Kondratenko G.G., Puchkov A.F. The nature and features of severe acute pancreatitis according to the results of pathomorphological studies. Novosti khirurgii = News of surgery. 2014;22(3):296–305. (In Russ.)
5. Timerbulatov V.M., Mustafin T.I., Timerbulatov M.V., Galieva A.K. Variants of the spreading purulent-necrotic process with destructive pancreatitis. Khirurgiya = Surgery. 2008;(4):31–35. (In Russ.)
6. Matsuda Y., Masuda Y., Shimoji K., Matsukawa M., Kinowaki Y., Fukumura Y., Kikuyama M., Arai T. Severe Acute Pancreatitis in Autopsies Associated With Surgeries and Severe Inflammatory Diseases. Pancreas. 2019;48(10):1321–1328. doi:10.1097/MPA. 0000000000001423
7. Mayorov V.M., Dundarov Z.A. Morphological patterns of damage and spread of the destructive process in the retroperitoneal space in severe acute necrotizing pancreatitis according to autopsy data. Novosti khirurgii = News of surgery. 2015;23(4):385–390. (In Russ.)
8. Fedorina T.A. Rukovodstvo po sektsionno-biopsiynomu kursu = Sectional biopsy course guide. Moscow; Samara: SMS, 2001:93. (In Russ.)
9. Imaeva A.K., Mustafin T.I. Features of postmortem examination in acute destructive pancreatitis. Morfologicheskie vedomosti = Morphological bulletin. 2020;28(2):48–54. (In Russ.). Available at: https://doi.org/10.20340/mv-mn.2020.28(2:48-54
10. Protsenko S.I., Nadeev A.P., Viskunov M.P., Fedorenko V.N. Pathomorphological changes in the pancreatic duct system in fatty and hemorrhagic pancreatic necrosis in experiment. Arkhiv patologii = Archive of pathology. 2011;73(1):38–40. (In Russ.)
11. Avtandilov G.G. Osnovy kolichestvennoy patologicheskoy anatomii = Fundamentals of quantitative pathological anatomy. Moscow: Medi-tsina, 2002:240. (In Russ.)
12. Abrikosov A.I. Tekhnika patologoanatomicheskikh vskrytiy trupov = Technique of pathological autopsy of corpses. Moscow: Medgiz, 1948:166. (In Russ.)

 

Дата создания: 23.11.2021 14:20
Дата обновления: 25.11.2021 13:35