Volume 03 Issue 08-2023
58
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
58-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Patients aged 65-89 years who were treated for pancreatitis of biliary etiology were analyzed. In the following physical
examination, the general condition, characteristics and intensity of pain syndrome, symptoms of intoxication and
disorders of central and peripheral hemodynamics are determined, peristaltic bowel sounds are studied and
characteristic percussive and ascultatory symptoms are determined; Changes in percussive sounds associated with
dynamic bowel obstruction, circulatory disorders were evaluated.
KEYWORDS
Biliary pancreatitis, geronological, prophylactic.
INTRODUCTION
in Europe and the United States, on average, the
incidence of acute pancreatitis is 11-23 people per
100,000 inhabitants per year; in 2000, the highest
incidence was 40 people per 100,000 inhabitants,
including severe cases of exacerbation of chronic
pancreatitis [3, 4]. In many countries, the most
common causes of acute pancreatitis are cholelithiasis
(30-50%), which is called biliary pancreatitis, and next is
Research Article
CLINICAL WITHDRAWAL DISORDERS OF BILIARY PANCREATITIS IN
ELDERLY PEOPLE
Submission Date:
August 18, 2023,
Accepted Date:
August 23, 2023,
Published Date:
August 28, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue08-08
Suyunov Dilmurod Muminovich
Andijan State Medical Institute Republic Of Uzbekistan, Andijan, Uzbekistan
Salakhidinov Sarvar Zaynobiddinovich
Andijan State Medical Institute Republic Of Uzbekistan, Andijan, Uzbekistan
Komiljonov Abdulaziz Elmurodjon Og’li
Andijan State Medical Institute Republic Of Uzbekistan, Andijan, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 08-2023
59
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
58-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
alcohol (20-30%), which is called alcoholic pancreatitis.
Across different countries, this ratio varies [3].
Together, these two causes account for 80-90% of all
acute pancreatitis, with the highest level of biliary
acute pancreatitis occurring in women aged 50-70
years, while alcoholic acute pancreatitis is observed in
men aged 30-40 years[3]. According to various
authors, 5-20% of all acute pancreatitis is caused by
idiopathic acute pancreatitis(op), the causes of which
can be factors such as hyperlipidemia, hypercalcemia,
acute infections and invasive treatments, medication
[3, 5].
The purpose of the work:
to identify and assess the
peculiarities of the clinical course of biliary pancreatitis
in the population population of the career of the
Gerontological group. The aging process inevitably
affects the course of pancreatic diseases, changing
their clinical picture and diagnostic and therapeutic
approaches in older people. In general, inflammatory
diseases of the pancreas in old age are not common in
young people, but both acute pancreatitis and chronic
pancreatitis occur in people over the age of 60, and
both variants have a number of distinctive features
compared to pancreatitis developed in other
countries. Among all pancreatitis in elderly patients, op
occurs in 40% of cases. Chronic pancreatitis is
approximately 25%. Elderly patients typically have
biliary pancreatitis (40-70%), ischemic (19-21%), and
idiopathic Genesis, with alcoholic pancreatitis
accounting for a very high proportion of patients [11,
13]. Many researchers insist that op often appears
against the background of cholelithiasis and has an
atypical course, which makes it difficult to diagnose.
Pain syndrome often has vague localization and is
unclear, and sometimes pain is completely absent. In
elderly patients with acute pancreatitis, the mortality
rate can reach 35%, but on average up to 20% - 25% [4,
10, 14] is observed. Elderly patients have a very high risk
of acute pancronecrosis complications, due to the
presence of polysistemic diseases, such patients
should be carefully monitored and actively treated[10,
15].
Park J. Analyzed data from 40 patients with acute
pancreatitis over 70 years of age. It turned out that
biliary acute pancreatitis occurs in 35% of the elderly,
idiopathic pancreatitis occurs in 30% of cases. The
mortality rate was 20%, and the cause of death in all
patients was polyorgan insufficiency, with such
complications only two patients survived. The
complexity of the diagnosis of acute pancreatitis is that
elderly patients usually have concomitant diseases of
the cardiovascular system, lungs, kidneys, liver, which
in turn can be an early manifestation of acute
pancreatitis. In this regard, differential diagnosis of
early symptoms of acute pancreatitis in older patients
is often difficult and goes into an already late stage
until the disease is diagnosed[16].
MATERIAL AND METHOD
Volume 03 Issue 08-2023
60
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
58-63
SJIF
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MPACT
FACTOR
(2021:
5.
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
65-89-year-old bmors treated with pancreatitis with
biliary etiology were analyzed at the Fergana regional
multidisciplinary hospital and RSHTYOIMFF. They
studied the general condition, pain syndrome
disorders and intensity, intoxication symptoms and
disorders of Central and peripheral hemodynamics in
the following physical examination. Intestinal
peristaltic murmurs, characteristic percutaneous and
auscultative
symptomatology
were
identified;
variations in percutaneous sounds associated with
dynamic intestinal obstruction, such as circulatory
disorders (at the base of continuous recording) were
evaluated (Table 1).
Table 1.
Timing and type of treatment (n-132)for the admission of elderly patients to the hospital
Time of application after
the onset of the disease
Intentivisible
conservative
treatment (n=79)
Laparotomic
tashrix
(n=37)
Laparoscopic tashrix (n=
16)
Абс.
%
Абс.
%
Абс.
%
Within 24 hours
54
68
24
64,8
10
62,5
Within 48 hours
14
18
8
21,6
3
18,7
Within 72 hours
11
14
5
13,6
3
18,7
Total :
79
100
37
100
16
100
According to the type of pancreatitis was allocated to
gurukhs:
I guru: swollen pancreatitis (59 people): basic -40,
control-19
Group II: sterile pancreonecrosis (32nafar): primary-17,
control-15
Group III: nosteryl pancrenecrosis (44 individuals):
primary
–
26, control-18
In acute biliary pancreatitis, however, over time, the
clinical picture of the disorder becomes more diverse.
Damage to vital organs prevents the obvious
manifestation of clinical signs characteristic of acute
pancreatitis. In elderly patients, the possibility of
Volume 03 Issue 08-2023
61
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
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P
AGES
:
58-63
SJIF
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FACTOR
(2021:
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
seeing the pancreas at UTT and determining the
condition of the charvi sac remains limited if intestinal
paresis is considered to develop very early in
abdominal pathology. With age, the number of various
changes in the human div increases. Because of this,
it is forced to regularly take various drug vosta. For
example in hypertension and ischemic heart disease,
after taking antihypertensive and antiagregant drugs
and diuretics, if a patient develops acute pancreatitis,
then there is an increase in the development of
hemorrhagic panrkeonecrosis and hemorrhagic
syndromes. In Old Age, various diseases and
atherosclerosis of blood vessels develop, and under
the influence of it, the sensitivity of the nerve endings
decreases, so that the intensity of pain decreases
unambiguously. At the same time, the development of
cerebral circulatory failure prevents the detection of
pain localization. In Old Age, water salt metabolism
becomes more difficult due to increased metabolism at
the same time in most elderly, as a result of regular
intake of diuretics due to companion disease, the
process of dehydration in patients develops much
faster and increases the risk of polyorgan deficiency.
Morphological changes characteristic of the elderly in
the gastrointestinal tract lead to rapid paresis of the
intestines in acute surgical diseases such as
pancreatitis, cholecystitis and appendicitis in the
gastric intestinal system, and this process also changes
the typical clinical course of the disease.
In our clinical observations in patients with
pancreatitis with biliary etiology aged 65-89 years, the
above cases have found their proof(Table 2).
Table 2.
Clinical signs of patients with biliary pancreatitis the manifestation of age-related Halda
Age
Belt pain
Vomiting
Intestinal
paresis
Hypovolemia
А
BS
%
А
BS
%
А
BS
%
А
BS
%
I (n=59)
65
–
75
45
76
47
79,6
24
40,6
47
79,6
II (n=31)
76 - 85
24
77,4
29
93,5
28
90,3
29
93,5
III (n=42)
86
–
89
19
45,2
38
90,4
39
92,8
38
90,4
As can be seen from the table, the clinical signs of
elderly patients with biliary pancreatitis undergo
various levels of changes with age. The intensity of the
pain is manifested in the age range of 65-85 years.
Volume 03 Issue 08-2023
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International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
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P
AGES
:
58-63
SJIF
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FACTOR
(2021:
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
From the age of 86, however, the intensity of the pain
decreases and it ceases to have a pronounced
localization. If nausea is observed in all patients, the
number of vomiting increases with age, which is
associated with the early development of intestinal
paresis in the elderly. The increase in the number of
vomiting as described above and the dehydration of
tissues to the condition of old age leads to a rapidly
developing pipovolemic state in elderly patients. In
addition, due to the fact that enzymatic activity is also
not high with age, patients have ham associated with
diseases and medications they are taking. Therefore, it
will be necessary to observe special attention and strict
requirements for the diagnosis and treatment of
Gerontological patients.
Hulosa: in older people, the diagnosis and treatment of
pancreatitis is a difficult problem due to a number of
additional conditions: polymorbidity, changes in the
pharmacokinetics of drugs, leads to an atypical course
of the disease. For this reason, in the diagnosis of
clinical diagnosis in the elderly, an MSCT examination is
born, at the same time an exertion to determine the
amount of Alpha microglobulin. Knowing these
peculiarities of the elderly, the patient ensures the
sufficiency of timely diagnosis and treatment, prevents
complications and improves the quality of life of
patients.
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