The pancreas (pancreas) is an important organ of the gastrointestinal tract, which is responsible for the secretion of digestive enzymes and the regulation of carbohydrate metabolism in the body. Pathologies of this important digestive and endocrine organ have characteristic signs that are manifested in the localization, nature of the pain syndrome, and accompanying symptoms. However, patients who do not know what functions the pancreas performs, where that organ is located, and how it hurts, may not recognize the symptoms of the allergy and do not consult a doctor in time.
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What is the pancreas?
The pancreas (PZHZH) is an internal organ of the digestive and endocrine systems that consists of two parts: the exocrine (extaocrine) and the intrasecretory (endocrine).
The secretory part of the gland is represented by cells that produce pancreatic juice (acini) and an extensive system of ducts, which ensures the outflow of digestive juice from acin and its delivery to the intestine. The small PZHZh pipes are connected into larger ones, which then enter the main (Wirsung) channel.
The pancreatic duct system connects the pancreas to the biliary tract and the duodenum. This anatomical structure is caused by the fact that more than 30% of pancreatic pathologies are secondary and develop due to diseases of nearby organs.
The intrasecretory part of the gland is significantly inferior to the exocrine gland in size: its mass is not more than 2% of the total mass of the organ. This part is a small islet of endocrine tissue (Langerhans islands), which is surrounded by the exocrine part of the pancreas. The islets of Langerhans are located mainly in the caudal part of the organ.
Severe diseases of the exocrine gland can also affect Langerhans' islands: their hormonal function may be impaired with severe inflammation of the main mass of the PZHZh parenchyma or the presence of large cancer.
Body functions
In accordance with the structure of iron, it has two functions: exocrine and endocrine.
Every day, exocrine cells in the body produce 0.5-1 liters of pancreatic juice, which consists of water, acid salts, and digestive enzymes that break down incoming nutrients before they are delivered to the gut.
Substances produced by acini are inactive pro-enzymes, which exclude damage to the tissue that secretes the most. The pancreatic duct system connects the pancreas to the biliary tract and the duodenum.
Stimulation of pancreatic enzyme function occurs when the stomach and intestines interact. Gastric juice, which contains hydrochloric acid, enters the small intestine and stimulates the production of cholecystokinins and secretin, which activate acini.
The exocrine gland secretes the following enzymes:
Amylase. This enzyme breaks down complex carbohydrates into easily digestible disaccharides and oligosaccharides.
Lipase (cholesterol esterase, phospholipase A and lipase). Lipases break down fats that have been previously treated with bile acids. Bile activates the first two enzymes and inhibits the action of the third, but the pancreatic juice contains colipase which preserves the structure of the lipase.
Protease (trypsin, chymotrypsin, elastase, carboxy- and aminopeptidase). Proteases are involved in the digestion of protein compounds. They break down the peptide bonds of proteins and separate amino acids from them.
The pancreatic juice has an alkaline pH, which allows it to neutralize the action of gastric juice in the digestion of carbohydrates.
An exocrine function is regulated by the nervous system, which binds the intensity of pancreatic enzyme production to the diet. The juice's composition is determined by the ratio of protein, fat, and carbs in the meal.
The islets of Langerhans (endocrine part of the pancreas) consist of 5 types of cells, each of which produces its own hormone:
Alpha cells. These cells produce the hormone glucagon, which increases blood sugar levels during exercise, or has the opposite effect of insulin. This portion of the Langerhans islets is also crucial in the prevention of fatty hepatitis. The proportion of alpha cells is up to 20% of the mass of the endocrine part of the pancreas.
Beta cells. They are responsible for the production of insulin and regulate the metabolism of carbohydrates and fats. With the participation of this hormone, body tissues accumulate glucose, reducing its content in the blood. Beta cells are the most important part of the intra-secretory part of the organ: their share is up to 80% of the mass of endocrine islets.
Delta station. Cells of this type produce the hormone somatostatin, which inhibits the activity of several endocrine glands, including the pancreas. This hormone is also produced in the main regulatory organ of the endocrine system - the hypothalamus. The proportion of delta cells in the intrasecretory part of the pancreatic fluid does not exceed 10%.
Pp cells are responsible for the secretion of pancreatic polypeptide (PP), which inhibits the production of enzymes by the gland itself and stimulates the production of gastric juice. The proportion of PP cells is up to 5% of the mass of the endocrine part of the organ.
Epsilon cells. Epsilon-type cells, whose share is less than 1% of the mass of endocrine islets, produce the so-called "hunger hormone" ghrelin, which stimulates appetite.
The destruction of alpha and beta cells leads to serious consequences for the body, as hormones that regulate carbohydrate metabolism are produced only in the pancreas.
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Where the pancreas is in humans
The pancreas is located in the abdominal cavity at the level of the first lumbar vertebra (in newborns - at the level of the posterior chest). It is positioned below the abdomen in the horizontal posture of the body, which gives rise to its name. The regulate connects closely with the duodenum, stomach (separated from it only by the sac), aorta, and large intraabdominal vessels (inferior vena cava and left renal vein).
PZhZh consists of three parts:
Head. The head of the pancreas is covered with a duodenum, which forms a horseshoe around that part of the organ. The portal vein is positioned in a groove that separates the head from the body.
Body. The anterior surface of the gland body is located near the posterior wall of the stomach, the posterior surface is adjacent to the intraabdominal aorta and the lumbar spine. The lower part of the body PZHZH is located just below the root of the colon.
Tail. The conical tail of the organ enters the left hypochondria and reaches the spleen.
Pancreatic sizes
The size of PZhZh varies depending on the age of the person. In newborns, the length of this important digestive organ does not exceed 5 cm, and the weight is 3. Up to 1 year of the child's gland length is 7 cm, for 10 years - 15 cm. PJW gains final dimensions and weight only at the age of 16 years.
The length of the gland in an adult is 15–23 cm, and the weight is 70–80 g. The width of the gland head starts from 5 cm, the thickness is 1.5–3 cm, and the length is up to 3.2 cm.
The body is the longest part of the body, but not the widest: the width of the body of the pancreas is 1.75 to 2.5 cm.
The width of the tail of the gland does not exceed 1.5 cm, and the length is 3-3.5 cm.
Deviations from the normal size of the pancreas are allowed only in small limits and in the absence of signs of pathology in the results of laboratory diagnostics.
How the body hurts
The specificity of the pain syndrome depends on the location of the gland lesion, its type (diagnosis), and the presence of concomitant or primary pathologies that cause pancreatic disease.
The defeat of the gland head is accompanied by pain and discomfort “below the spoon” (in the central part of the abdomen) or right hypochondria. Despite the predominantly left position of the organ, local inflammation or neoplasm of the head can cause pain on the right side. With the defeat of the body, the pain is clearly felt to the left of the midline, and in the case of tail disease, to the left of the navel.
Diffuse discomfort in the upper abdomen indicates that the whole gland is inflamed.
.The nature of pain and the time of its occurrence can be as follows:
sharp incision or intense pain, which does not depend on food intake (with acute inflammation of the gland);
nausea, which occurs after eating, lowering when leaning forward (with chronic inflammation, cysts, tumors);
worse at the end of a meal (when the ducts are blocked and the intraductal pressure increases);
any nature of discomfort, accompanied by nocturnal pain (duodenal lesion 12, complicated by PZHZH disease);
colic of the pancreas (with stones in PZHZH).
With atrophy of the glandular functional tissue and progression of enzyme failure, the severity of the pain syndrome decreases. Dull aching pain is replaced by colic, which has no exact localization.
Pain in the gland area can be given to many parts of the body: in case of pancreatic pathology, pain in the left half of the sternum, retrosternal and epigastric areas, left arm and shoulder blade, groin, and even lower jaw. In some cases, the painful syndrome is felt immediately throughout the abdominal cavity.
Determining the cause of pain without consulting a doctor and further research is difficult. Pancreatic pathologies are often taken to exacerbate chronic pathologies of the heart, kidneys, and back and are not diagnosed in time.
What can be diseases
Pancreatic diseases include the following pathologies:
- Acute pancreatitis. PJV inflammation is the most common disease of this organ. It is accompanied by pain, diarrhea, cracking under the ribs, nausea, and other symptoms. Pain in acute inflammation is weakly sensitive to the action of antispasmodics and painkillers.
- Chronic inflammation of the gland. In the chronic process, the pain is less intense and occurs when overeating, alcohol consumption, fatty and irritating foods.
- Enzyme deficiency. Enzyme deficiency can be congenital or acquired (for example, in chronic pancreatitis). The pathology is manifested by a change in the color and amount of stool, darkening of the urine, nausea, a feeling of overfilling the stomach, weight loss, and symptoms of lack of protein and trace elements.
- Stones in PZHZH. Calcinates in glandular tissues are formed mainly in the case of alcoholic organ lesions, parathyroiditis, and a burdened family history. Burning pains in the upper part of the abdomen, characteristic of this pathology, are accompanied by nausea, vomiting of bile, increased fatty feces, increased salivation, etc.
- Cysts and fistulas. Liquid capsule-bound formations may be asymptomatic (with small cysts) or obvious signs of enzyme deficiency, jaundice, pain in the left hypochondria and epigastrium, nausea, and vomiting (with duodenal compression). Fistulas result from spontaneous cyst rupture, acute destructive pancreatitis, or glandular bruising.
- Benign neoplasia. Hypertrophy of the adipose, glandular, or connective tissue of the gland may not last long for any symptoms. In large benign tumors, jaundice occurs, caused by squeezing of the bile ducts, and intestinal obstruction. An increase in glandular tissue volume can cause attacks of palpitations, hand tremors, and partial limb paralysis.
- Glandular cancer. Malignant diseases are characterized by digestive disorders (loss of appetite, pain in the hypochondria, discoloration of urine and feces) and general symptoms (weakness, rapid weight loss). In endocrine gland tumors, symptoms of hormonal imbalance appear.
- Type 1 diabetes. Autoimmune damage to the islet cells of the islets of Langerhans leads to a decrease in insulin production and the inability to consume glucose by insulin-dependent body tissue. Diabetes is manifested by frequent urination, strong thirst, and increased appetite. In the absence of the introduction of artificial insulin, severe complications occur (diabetic blindness, kidney damage, polyneuropathy, coma).
With the exception of acute pancreatitis (symptoms in women are less common than in men), diseases of the pancreas with the same frequency occur in patients of different sexes.
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