Functional state of the pancreas in adolescents with peptic ulcer of duodenum
DOI:
https://doi.org/10.14739/2310-1210.2018.4.135321Keywords:
duodenal ulcer, adolescents, pancreas, diagnosisAbstract
The aim of the study. To define the functional state of the pancreas in patients aged 13–17 years suffering from duodenal ulcer.
Materials and methods. The study involved 97 adolescents with duodenal ulcer in combination with functional pancreatic disorder and without it. In addition to conventional diagnostic algorithm for duodenal ulcer and pancreatic diseases the sonography with detailed visualization of the pancreas by method of B. M. Tarasyuk was performed. Endocrine function was estimated by the glucose tolerance test, fasting glucose and glycated haemoglobin levels. Helicobacter pylori was determined by ELISA and stool antigen test. Descriptive statistics for quantitative indices were represented by absolute and relative values, mean value, standard deviation, median, minimum and maximum values, number of observations. For qualitative (discrete) indicators frequencies and percentages were used. To determine the level of statistical significance (P) the change from the initial level and the correlation between the indicators computer program “Statistica for Microsoft” was used. The difference between the indicators (P value <0.05) was considered statistically significant.
Results. The lesions of pancreas were mostly found in boys older than 16 years with disease duration of 0.5 – 3 years. The clinical picture of comorbidity manifested by pain in the left hypochondrium and pyloroduodenal area and tenderness in the area of Gubergriz-Skulskyj. Amylase in blood plasma and urine in children of the main group was lower than in the comparison group. The significant differences in indicators of fecal elastase-1 levels in the first and second groups were estimated. Coprogram parameters were not sufficiently informative, and dominant sonographic features included the pancreas head edema and increased echogenicity of the parenchyma with the presence of linear hyperechoic echoes.
Conclusions. Ulcer disease in 13–17 years old adolescents is accompanied by impaired pancreatic function in 51.5 % of cases. Among the clinical picture features the pain in the left hypochondrium (76.0 %), pyloroduodenal area (50.0 %) and in the Gubergriz-Skulskyj zone (30.0 %) should be noted. Exocrine pancreatic function impairment was observed only in the I patients group in terms of diastase in urine and fecal elastase-1 activity changes. Endocrine pancreatic function changes in patients with peptic ulcer were not observed. Among the sonographic criteria of pancreatic lesion in duodenal ulcer the main ones were identified: linear hyperechoic echoes (48.8 %), increased echogenicity of the parenchyma (34.8 %) and these two parameters combination (16.4 %).
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