ABOUT PATHOGENIC MECHANISMS OF CARDIOVASCULAR REACTIONS DURING ACUTE PANCREATITIS AND PANCREONECROSIS

F.KH.ALIYEV, G.J.MAMMADBAYOVA, A.E.MUZAFFARZADE

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku, AZERBAIJAN

At present, being one of the severe pathologies of abdominal cavity, acute pancreatitis is one of the actual unsettled problems of modern abdominal surgery. Necrosis of pancrecytes resulting in further inflammatory infections and ferment autoaggression in most cases lead to the acute diseases of pancreatic gland beginning with aseptic inflammation. But according to its growth trend, acute destructive pancreatitis prevail over other urgent diseases of abdominal cavity, an in case of this pathology total mortality constitutes 45-67 %. Although the stable high level of mortality in acute pancreatitises is explained by complex pathogenesis of the disease, some realization mechanisms of pathologic reactions remain unknown. The conducted studies show that activation of polypeptide matters the result of increase of pancreactic enzymes in blood during acute pancreatitis causes the formation of microhemodynamic changes, which leads to metabolic and structural changes in some organs. Therefore, morpho-functional disordes forming in the cardio-vascular system are of great significance. Involvement of the cardiovascular system to the pathologic process during acute pancreatitis is conditioned by higher severity of the disease. Thus, impaired coagulation and hemoconcentration on the background of inflow of ischemic toxins into blood during pancreonecrosis leads to severe disorders of coronary perfusion that result in ischemic dystrophy of myocardium. During destructive acute pancreatitises, under the influence of cardiodepressor agents morphologic and functional changes of myocardium, internal loss of liquid in parapancreatic tissues, serous sac and intestine and its pain syndrome causes sudden cardiac arrest as a result of acute hypovolemia. At the same time, in cases of death from ischemic heart diseases, numerous hemorrhagic pancreonecrotic focues and hemorrhage are observed. Some investigators associate the main role in the pathogenesis of the coronary syndrome during acute pancreatitises with viscero-visceral reflex transferring impulses from celiac plexus to heart. Based on the clinical and experimental examinations it can be said that the development of coronary syndrome during acute pancreatitis occurred under the complex neuroreflectory mutual influence of celiac and cardiac plexuses, and under direct damaging influence of proteolitic enzymes and endogenous toxic products on myocardium. Despite functional significance of such morphologic changes, the changes occurring in the nervous apparatus of heart in the complex of cardiovascular reactions have not been completely studied. All the abovementioned once again shown a great need in the analysis of complications occurring in acute pathologies of pancreatic gland from the cardiologic point of view.

Date: 2014-12-28; view: 930