Ways to optimize postmortal diagnostics of acute destructive pancreatitis

Abstract

Background. The purpose of the research is to improve the pathological diagnosis of acute destructive pancreatitis. Materials and methods. To solve the purpose, we have developed new tactical and technical methods of pathological examination of a corpse in acute destructive pancreatitis. Before the autopsy, a thorough study of the medical documentation is carried out, and the autopsy itself involves the study of organopathology, including at the light-optical level. This is necessary for understanding the mechanisms of thanatogenesis and establishing the immediate cause of the patient’s death. The autopsy technique is fraught with certain difficulties, since many of the subjects underwent surgical interventions during their lifetime. In this case, the pathological process covers the near and distant tissue structures. For a pathologist, it is important to understand the sequence of inclusion of other internal organs in the purulent-necrotic process. Results. The results of postmortem examination are presented. The main tactical and technical aspects were worked out on 65 corpses. In acute destructive pancreatitis, the introduction of a contrast agent into the duct system of the pancreas gives an idea of the ways in which the purulentnecrotic process spreads along the retroperitoneal tissue and other anatomical structures. The use of the device developed by the authors makes it possible to more accurately bring the contrast agent to the epicenter of the pathologically altered cellular structures of the retroperitoneal space, to predetermine the volume of the lesion and the pathway of fluid outflow. The variants of the dissemination of the purulent-necrotic process were studied, on the basis of which the types of acute destructive pancreatitis were proposed. Conclusion. The developed set of tactical and technical methods of pathological anatomical examination during the section of organs allows one to arrive at a qualitative clinical and anatomical analysis of the case in acute destructive pancreatitis.

Keywords

• acute destructive pancreatitis
• postmortem examination
• new techniques