CASE OF CHRONIC CALCULOSIS PANCREATITIS IN PATIENT WITH ALCOHOLIC CIRRHOSIS

• Main Authors: A. A. Yakushev, L. Yu. Ilchenko, I. G. Fedorov, S. Yu. Orlov, G. G. Totolyan, I. G. Nikitin
• Format: Article
• Language: Russian
• Published: SINAPS LLC 2018-02-01
• Series: Arhivʺ Vnutrennej Mediciny
• Subjects: calculosis pancreatitis; alcoholic chirrosis
• Online Access: https://www.medarhive.ru/jour/article/view/749
• ISSN: 2226-6704; 2411-6564

The article describes clinical features, differential diagnosis and treatment of chronic calculouse pancreatitis (HCP) with alcoholic liver cirrhosis (LC). Considered etiologic role of chronic alcohol  intoxication in the development of these diseases. There was long- term use of alcoholic beverages at hepatotoxic doses and smoking in anamnesis. Patient was examined before entering in our clinic.  Сhronic heart failure, nephrotic syndrome, paraneoplastic was  excluded as the cause of hydrops. Patient R. was hospitalized in the  gastroenterology department with ascites of unknown etiology. The  severity of the patient’s condition is caused by malabsorption  syndrome and hepatocellular insufficiency leading to the  development of edema-ascitic syndrome and trophological failure. In patient there was low of proteins (total protein — 38 g / l), low of  albumins (14 g / l). In carrying out endoscopy showed signs of portal hypertension: esophageal varices 1 degree, portal gastropathy; In addition, an increase in the size of the papilla of  Vater. To clarify the nature of the defeat of the pancreas held  endosonography, in which multiple calcifications are found in the  pancreas tissue. To resolve biliary hypertension performed stenting of the common bile duct. Drain the pancreatic duct failed due to the presence of calculus in it at the level of the isthmus. Treatment for  our patient should be considered the imposition Ru’s operation. This  observation demonstrates social importance of problems of  combination HCP with a LC, which lead to reduced quality of life,  early disability, reduced life expectancy, as well as to an increase in treatment costs.