[Endogenous toxemia in pancreatic necrosis of alcoholic etiology]

Operation for pancreonecrosis was carried out in 197 patients, in 52 (26.4%) of them the disease was of alcoholic etiology. The disease was marked by severe clinical manifestations with the development of respiratory, hemodynamic, and peritoneal syndromes and their complications, and by psychic disorders. The endo-intoxication structure was studied in 13 patients by mass-spectrometry proceeding from alcohol metabolism in the organism. Eleven intermediate products were identified: ethanol, acetaldehyde, normal butyraldehyde and isovaleric aldehyde, diethylamine, acetone, isopropanol, methyl isocyanide, trimethylamine, ethannitrile. It was noted that the clinical manifestations of alcoholic pancreonecrosis are included in the spectrum of ethanol pharmacological action; the content of ethanol in the blood was tenfold of the normal, that of the product of its metabolism acetaldehyde was 1.6 times the normal level. Inclusion of exogenic ethanol in metabolism leads to its distortion and accumulation of substances of different origin in the organism, among which an important role is played by acetaldehyde, normal butyraldehyde, and isovaleric aldehyde. The results of the study create proconditions for the search for a rational means for their desactivation.