[POSSIBILITY OF EARLY GASTRODUODENOSCOPY IN ASSESSING OF SEVERITY AND LOCATION OF THE NECROSIS IN ACUTE BILE...

In prospective cohort study of 100 patients with acute bile pancreatitis studied endoscopic upper gastrointestinal changes depending on the location of the zone of inflammation and necrosis in the pancreas and the severity of the pancreatitis. In the overall structure changes were the most common finding of a violation of lymphflow--lymphangiectasia--67%. From 29% to 44% of patients had evidence of acute inflammation in the stomach and duodenum. Every fourth patient noted pain in moving the endoscope in the stomach or duodenum. However, direct signs of obstructive acute bile pancreatitis occurred in only 7% - 15% of cases, although extended intramural bile duct as a sign of bile hypertension occurred in 25% of cases. Revealed significant differences in the frequency of endoscopic evidence of the localization of necrosis in the head, body or tail of the pancreas. Also revealed significant differences in the structure of endoscopic findings in depending on the severity of the pancreatitis. It is shown that direct signs of obstructive bile pancreatitis is not related to the localization of inflammation, but have a close relationship with the severity of bile pancreatitis. Thus, a qualified assessment of upper gastrointestinal changes in acute bile pancreatitis can improve the topical diagnosis of necrosis in the pancreas and the early evaluation of the severity of bile pancreatitis.