X-RAY, ENDOSCOPIC AND ULTRASOUND DI-AGNOSIS OF ACUTE BILIARY PANCREATITIS

Aim.To evaluate the most typical signs in roentgenological, endoscopic and ultrasound examination of patients with acute biliary pancreatitis. Materials. A clinical examination and treatment of 126 patients with acute biliary pancreatitis have been performed. In 107 patients (84.9±3.19%), the clinical course of pancreatitis was considered as mild and moderate. Results. While performing radiography of the chest organs in a direct projection, there were signs of pancreatic-pleural syndrome. The effusion in the pleural cavity was found in 17 patients (OR 0.02; 95%; CI 0.01-0.05). In the roentgenological examination of the abdominal cavity there were often observed such symptoms as: symptom of Gobiet – in 48 (38.1±4.33%) (OR 0.38; 95%; CI 0.23-0.63); the symptom of Stuart – in 33 (26.2±3.92%) (OR 0.13; 95%; CI 0.07-0.22); pneumatized intestinal loops in the projection of the pancreas – (27.8±3.99%) (OR 0.15; 95%; CI 0.09-0.26); the Poppeltriad – 19.8±3.55% of cases (OR 0.06; 95%; CI 0.03-0.11). Endoscopy was performed in 57.9±4. 40% of patients: there were reflux esophagitis (93.2±2.96%) (OR 184.96; 95%; CI 51.20-668.14); erosive gastroduodenopathy (89.0±3.66%) (OR 66.02, 95%, CI 23.37-186.50), swelling of the major duodenal papilla (78.1±4.84%) (OR 12.69; 95%; CI 5.79-27.80). Ultrasonography was used in all patients. In 16.7±3.32% of patients there was no gall bladder. When performing ultrasonography it was possible to verify the actual biliary genesis of pancreatitis. Conclusions.Ultrasound is the most specific in acute biliary pancreatitis and allowsto verify the following: an increase in the size of the pancreas, the blurring of its contours, the associated acute calculouscholecystitis, the contents of the omental bursa.