[Early diagnosis of acute pancreatitis]

The article discusses clinical experience of the Sklifosovsky Emergency Ambulance Service Institute in establishing early diagnosis of acute pancreatitis in the last decade. Over 3,000 patients were examined; they were admitted to the Institute for acute pancreatitis the diagnosis of which was made according to the program of complex diagnosis at the stage of the admission department and during the first three days of the hospital stage. The decisive role in establishing the diagnosis is attached to the clinical manifestations, medical history, amylasuria, and obligatory radiological and ultrasonographic examination (USE). The characteristic radiological and ultrasonic signs of various forms of acute pancreatitis are described. Radiological pleuro-pulmonary signs were found in 15.1% of patients with the edematous and in 42% of those with destructive pancreatitis. Specific indirect signs during radiography of the abdominal organs were registered in almost 80% of cases of acute pancreatitis. Informativeness of USE in acute pancreatitis was 95.4%, and it also made it possible to identify the clinico-morphological form of the disease. It is emphasized that USE must be undertaken in the first hours of the patient's admittance to the clinic. The suggested complex program of early diagnosis may be used in essence in all emergency ambulance service hospitals.