PANCREATOGENIC MORPHOSTRUCTURAL CHANGES IN THE HEART, LUNGS AND OTHER TARGET ORGANS IN DESTRUCTIVE PANCREATITIS

Abstract

Introduction. Pathomorphological changes in destructive pancreatitis develop both in the pancreas and in various organs and tissues, it determining the clinical course and outcome of the disease. Most often in destructive pancreatitis, the cardiopulmonary system is affected, as well as the liver, kidneys, and brain. Damage to these target organs is one of the main elements of pathogenesis and thanatogenesis in destructive pancreatitis and is of interest not only for surgeons, but also for other clinical specialists, including cardiologists. Aim. To conduct a retrospective analysis of the most common morphostructural changes in the cardiopulmonary system and other target organs based on the results of autopsy reports of the deceased from destructive forms of acute and chronic pancreatitis and to identify the most characteristic morphostructural changes in the target organs. Materials and methods. A retrospective analysis of the findings of histological examination of target organs of 203 patients who died from acute pancreatitis (K.85) and chronic pancreatitis with an outcome of pancreonecrosis (K. 86) in the in-patient surgical departments and intensive care and resuscitation units of Minsk over the period of 2015-2019 was performed. Results. In the course of study, we investigated the nature and structure of morphostructural changes in the pancreas and target organs (heart, lungs, liver, kidneys, spleen, and stomach) in destructive pancreatitis. Conclusions. In destructive pancreatitis, deep dystrophic, necrotic, circulatory and inflammatory changes are observed not only in the pancreatic tissue, but also in the target organs, which are primarily the heart, lungs, liver, kidneys and brain. In the myocardium, edema, circulatory and dystrophic changes are detected, in the lungs - edema, circulatory changes and alveocyte damage. In the pancreas, necrosis, leukocyte infiltration and hemorrhages are noted, i.e. both necrotic and inflammatory changes are observed at the same time. In the liver, the most typical changes are leukocyte infiltration of the portal tracts, fatty dystrophy of hepatocytes, vascular fullness and dilation of capillaries, central veins and sinusoids. The kidney tissue is dominated by circulatory changes, necrosis and dystrophy of the epithelium of the convoluted tubules, which are the morphological substrate of acute renal failure. Edema, circulatory and dystrophic changes are detected in the brain.