Retroperitoneal Tissue Contrast Examination in Different Types of Acute Destructuve Pancreatitis

Abstract

Acute destructive pancreatitis refers to severe surgical pathology with high mortality. Destructive changes in this case cover both adjacent and distant structures. The aim of the study was to achieve a more accurate injection of the liquid contrast agent to the tissues of the retroperitoneal space affected by the purulent-necrotic process. We have developed a method that involves the use of a special device with a metal goniometer with a gradation of up to 180° with clamps to fix the syringe with a needle. Syringe with a needle is fixed in the device at an angle of 40° to 50° depending on the figure and the nature of the nutrition patients. The paper presents the results of contrast study of retroperitoneal tissue using the proposed device. The results of 63 cases of retroperitoneal space contrasting study through the right and left lumbar regions are considered. The use of the proposed method of contrast retroperitoneal area taking into account the figure and the nature of nutrition allows more accurately determine the variant of lesion of the pancreas and adjacent adipose tissue. The previously proposed methods of retroperitoneal tissues puncture in acute destructive pancreatitis (ADP) did not fully take into account the figure and the nature of nutrition of the subjects. A significant number (35%) of patients have an excess weight, especially among mesomorphs and endomorphs (91,4%). The figure and the nature of the nutrition of the subject should be provided in bringing the contrast into the retroperitoneal tissue, since this determines the angle of fixation of the needle in the device and the depth of its advancement. Puncture through the right lumbar region was carried out at I and II, through the left lumbar region - at III and IV types of ADP. Purulent necrotic lesions often equally cover the right and left parts of retroperitoneal tissue with type V of ADP.