Clinical and functional features in course chronic pancreatitis with accompanying duodenostasis

  The aim is to research the clinical features, functional state of duodenum among patients with chronic pancreatitis and accompanying duodenostasis. Materials and methods. The clinical course of chronic pancreatitis with accompanying duodenostasis (85 cases) and isolated chronic pancreatitis (56 cases) has been studied. Along with the general clinical data the study includes the results of exocrine pancreatic function examination (fecal elastase-1, blood alpha amylase and lipase) and its endocrine function (insulin and С-peptide). Regulating hormonal factors (gastrin and somatotropin) have been studied. Results of X-ray and endoscopic examinations, intraduodenal manometry results were used in verification of duodenostasis. Results. In the observation group resistant pain syndrome was revealed in 93% cases (in patients with isolated pancreatitis in 57% cases) with more expressed coprological syndromes (amilorhea in 82.29%, creatorhea in 82.14%, steatorhea in 87.5% cases). In the observation group hyperperistaltic (in 88% cases of observation group and in 9.4% cases of the comparison group) and duodenal hypertension (in 22% cases of observation group and in 0.0% cases of the comparison group) were significantly more diagnosed. The phenomenon of «semolina» was revealed more frequently in observation group (in 31.9% cases of observation group and in 5% cases of the comparison group). Among patients with chronic pancreatitis and accompanying duodenostasis the level of C-peptid decreased, while secretion of insulin, somatotropin and gastrin increased. Conclusion. It reveals that according to the comprehensive clinical and functional investigation chronic pancreatitis with accompanying duodenostasis gets a more severe course in comparison with isolated pancreatitis.