Zones and pain points in pancreatitis: phrenicus symptom

In a world where there is no time for proper and balanced nutrition, diseases of the pancreas are often diagnosed - pancreatitis, diabetes, and other diseases associated with harmful eating habits.

Inflammation of the internal organ is manifested by excruciating pain, which is not amenable to treatment with painkillers, accompanied by repeated vomiting, loose stools, and digestive disorders.

The pancreas is closely related to other internal organs. If its functionality is violated, it affects the work of the whole organism. However, it is impossible to make a diagnosis at one clinic; laboratory and instrumental examinations are needed.

So, what do pain points mean for pancreatitis? Consider the symptoms of Chauffard, Kach, Mayo-Robson and other doctors, which are determined by palpation.

Diagnosis and principles of palpation in pancreatitis

According to the general clinical manifestations, it cannot be argued that a sharp deterioration in the patient's well-being is associated with an acute attack of pancreatitis. In addition to the form of the pathological process, there are various types of inflammation of the pancreas, which are associated with negative consequences of a different nature.

To make the correct diagnosis of the patient must be carefully examined. The patient is tested for blood, urine, a coprogram, ultrasound, X-ray, CT, MRI.

Physical examination for suspected development of acute inflammatory process involves palpation according to established methods. This method is based on sensations of pain in certain places and percussion of the investigated area. Each picture has its own symptoms.

The areas for pancreatitis are named after the authors, named after medical specialists who investigated the indicated signs. For example, Chauffard symptom with pancreatitis, Kach and other doctors.

Palpation as a diagnostic tool began to be used at the end of the 20th century, when there was no specialized equipment to help identify the causes of acute pain and indisposition in a patient. Doctors used their fingers during the examination. In modern medical practice, the method of palpation complements the technology - ultrasound, MRI.

Its advantage lies in the fact that with the help of palpation it is possible to quickly suspect acute pancreatitis, respectively, to begin an adequate treatment as soon as possible. In an adult who has no functional disorders of the pancreas, it is impossible to palpate the organ.

Against the background of palpation and percussion in the area of ​​the pancreas, it is necessary to closely monitor the change in the nature of the pain syndrome in a patient.

The main symptoms

When making a diagnosis, palpation is a part of the diagnosis, indicating the localization of painful sensations, their change in the process of pressure. Symptom Resurrection with pancreatitis is defined as the lack of susceptibility of the aortic wall beats - in the area of ​​contact with the pancreas.

This point is located five centimeters above the navel with a shift of four centimeters into the projection area of ​​the gallbladder. To determine the sign of the Resurrection, you need to hold your fingers from the epigastric region to the projection of the liver by stretched thin clothing. In 70% of acute pancreatitis a positive result is detected. In medicine, this symptom has a different name "sign of the shirt."

The clinical manifestation of Mayo-Robson is determined by pronounced painful sensations in the zone, which is located in the projection of the body and tail. To determine the point mentally draws a line from the navel to the middle of the lower left rib. Soreness will be felt on a third of this line.

This symptom is inherent in 50% of clinical pictures. It can be determined by pressing lightly - increased pain indicates the development of an acute attack.

Other symptoms:

  • Chauffard zone. Soreness is defined between the anterior midline and the line that connects the navel to the right armpit and the perpendicular lowered to the midline of Desjardin;
  • Symptom Curte - pain with palpation in the zone, which is localized 5 centimeters above the navel strictly in the central direction. Found in 65% of the paintings. Also, a sign is considered positive if tension in the abdominal muscles in the epigastric region is detected;
  • Point Kacha with pancreatitis is a pain on the background of touching the projection of the tail of the organ of the digestive system. Point location: area of ​​the transverse process of the 8th thoracic vertebra. In some situations, chronic pancreatitis may manifest as an increased susceptibility of the skin in this area;
  • Razdolsky sign is detected in almost all cases of acute pancreatitis. Accompanied by sharp pain that occurs during percussion on the skin in the area of ​​the projection of the pancreas. Based on a pronounced inflammatory process of the abdominal cavity.

However, for the diagnosis of the result of palpation is not enough - always a comprehensive diagnosis, because an acute attack can be triggered by other diseases - cholecystitis, cholelithiasis.

The presence of the described symptoms is the reason for the hospitalization of the patient for further examination in the hospital.

Symptoms of palpation

In addition to those listed above, there are other signs that are named after doctors and are determined by palpation. Those that have already been described appear to be the most common, respectively, most often resort to their help.

According to doctors, the symptom of Mondor manifests itself in almost all cases of acute or reactive pancreatitis. Accompanied by the appearance of dark spots of blue on the skin of a person. They appear both on the body and on the face. The reason is the penetration of toxic substances that are released by the pancreas into the circulatory system - after they fall into the layers of the skin.

The symptom of Grotta is characterized by a pronounced pain syndrome, which is detected at certain points. There are several, each has its own name, helps confirm the inflammatory process in the tail, body or head of the gland.

Palpation is governed by the following symptoms:

  1. Desjardins. The pain manifests itself at a point that is located in 4 centimeters above the navel along the line connecting it with the armpit. Positively in 71%, especially against the background of a destructive disease.
  2. In acute inflammatory process, a positive reaction is often detected when pressure is applied to the zone, which is located in the fossa of the sore muscles. The name of the symptom is a sign of Mussi-Georgievsky. It is caused by severe irritation of the abdominal wall, irradiation of the nerve endings.

It is worth noting that the symptom of Mussi-Georgievsky is positive not only against the background of pancreatitis, but also with inflammation of the gallbladder, perforation of the ulcer. Therefore, its presence is not a definitive diagnosis; differential diagnosis is required.

Symptom Tuzhilina accompanied by the appearance of spots of red color on the skin, the size of which is up to 4 millimeters. Determined by the recurrence of sluggish inflammation.

Treatment of an acute attack is carried out in the hospital. After discharge, you need to follow a diet, take medications prescribed by a doctor. Additionally, they use non-traditional methods - massage complexes, acupuncture, herbal decoctions, etc.

Information on the symptoms of pancreatitis is provided in the video in this article.

Watch the video: Abdominal Dermatomes and Referred Pain (September 2019).