Why inflammation occurs in the bile ducts and how to treat it. Cholangitis: inflammation of the bile ducts

This process is also called cholangitis. Inflammation bile ducts may be acute, subacute and purulent. In most cases, the symptoms of the disease occur against the background of acute cholecystitis, but they can also be isolated. Treatment of inflammation of the bile ducts It is carried out by drugs and sanatorium-resort methods.

Symptoms of inflammation of the bile ducts

This is a lesion of the ducts that transport bile from the liver to the gallbladder and intestines. Most often, inflammation of the ducts is infectious in nature, and autoimmune diseases can be located at the origins of its development, in which immune cells produce antibodies against body cells and attack them. The main symptoms of inflammation of the bile ducts are:

Pain in the right hypochondrium

Feverish state

Enlargement of the liver

nausea and vomiting

As the disease progresses, the spleen may also become enlarged.

On the second or third day, the patient may develop jaundice, which is reflected in the change in the color of the skin and the color of the sclera. Also characterized by pruritus

Symptoms of inflammation of the bile ducts in purulent cholangitis

If observed purulent inflammation, the disease is more pronounced. An obligatory phenomenon is a sharp rise in temperature to 40 degrees. In severe cases, the disease can lead to the development of hepatitis, sepsis, and even hepatic coma.

The diagnosis of "Inflammation of the bile ducts" is made on the basis of the characteristic clinical picture. Laboratory data provide additional data to clarify the patient's condition.

In the presence of a sharp inflammation in the blood is noted

an increase in the number of leukocytes,
increase in ESR,
as well as changes in indicators of biochemical analysis.

used to accurately diagnose inflammation.

cholangiography,
retrograde cholangiography,
gastroduadenoskopiya,
in rare cases, laparoscopy.

Symptoms of inflammation of the bile ducts of different types

In about 70% of cases, patients with cholangitis have three symptoms: pain in the abdomen, jaundice (occurs in about 80% of patients), and fever. At the same time, modern medicine distinguishes three types of disease

acute,
sclerosing
and chronic.

Acute inflammation of the bile ducts begins suddenly. Its main manifestations are fever, severe pain on the right in the upper abdomen, which radiate from the right side to the shoulder, shoulder blade and neck. In addition, most patients develop jaundice.

Sclerosing inflammation of the bile ducts most often affects men under the age of 40 years. With its development, the infection is not detected, but the disease progresses, gradually blocking the lumen of the bile ducts and leading to the development of cirrhosis of the liver. Patients may have persistent or intermittent signs of jaundice, which is accompanied by pruritus. A dull pain appears in the right upper abdomen and hypochondrium.

The most common form of duct inflammation is chronic cholangitis. Its development is promoted by chronic cholecystitis, cholelithiasis and other diseases of the biliary tract. In the vast majority of cases, the manifestations of chronic cholangitis are almost invisible. Most often, patients experience great fatigue, small raises temperature. In the right hypochondrium, a dull pain may occur, or a bursting or squeezing can be felt.

Treatment of inflammation of the bile ducts

For therapy use:

Antibacterial treatment of inflammation, broad-spectrum antibiotics are preferred.

Antispasmodics

inflammation treatment choleretic drugs

If it is impossible to achieve a positive result exclusively with drug therapy, doctors use surgical treatment of inflammation - removal of stones, elimination of factors leading to narrowing of the lumen of the bile duct.

In the stage of remission, the spa treatment of inflammation of the bile ducts has a positive effect.

Why does bile duct inflammation occur?

A possible cause of cholangitis could be an autoimmune disease in which the body makes antibodies against the body's own cells. Inflammation of the bile ducts in most cases is caused by infectious agents such as streptococci and staphylococci, as well as a number of others. With a decrease in the rate of movement of bile, the pathological process is able to progress.

Inflammation of the bile ducts can develop as a complication of diseases of the gallbladder and cholelithiasis, but occasionally it can also be a primary disease. Among the main factors that cause inflammation of the bile ducts, we can distinguish:

stagnation of bile;

cicatricial narrowing of the bile ducts and their outlets;

damage to the mucous membrane of the biliary tract stones;

symptoms of inflammation are caused by blockage of the biliary tract by helminths

with a combination of stagnation of bile with a violation of the mucous membrane, inflammation of the bile ducts is caused by enterococci, staphylococci, Escherichia coli.

Inflammation salivary gland in medicine it is called sialoadenitis and is a disease of the salivary glands of an inflammatory nature with an acute or chronic course. Most often, the parotid salivary glands are affected by the inflammatory process.

Sialoadenitis is equally common in both adults and children. Also, the incidence of this disease is at the same level in men and women.

In acute inflammation of the salivary glands, the cause is almost always penetration pathogenic microorganisms inside the gland. Depending on the type of pathogen, the following forms of acute sialadenitis are distinguished:

viral etiology, which is most often caused by the mumps virus, since this virus is tropic to the glandular epithelium. The main route of transmission of the disease is airborne. Entrance gate to this case the mucous membranes of the mouth and throat protrude. The reproduction of the virus occurs in the glandular epithelium of the parotid salivary gland. In boys, there is also glandular tissue in the testicles, to which tropene virus mumps, so they can also be affected, which in some cases leads to infertility;
bacterial etiology. This form of sialadenitis develops both with exogenous and endogenous penetration of bacteria into the salivary glands.

Basically, the causative agents of acute sialadenitis are representatives of the normal microflora of the oral cavity. The following factors contribute to the development of the inflammatory process:

non-compliance with oral hygiene;
reactive narrowing of the ducts of the salivary glands. This state occurs against the background of general exhaustion of the body due to extensive surgical interventions on the organs abdominal cavity, cancer intoxication, chronic diseases of the digestive tract, stress, errors in diet or diabetes. The narrowing of the duct of the salivary gland leads to stagnation of saliva, which creates fertile ground for the life and reproduction of pathogenic microbes;
obstruction of the duct of the salivary gland. Obstruction of the duct is most often carried out by a calculus or a foreign body. In this case, the outflow of saliva from the gland is also disturbed, and optimal conditions are created for the reproduction of pathogenic bacteria.

Besides, acute sialadenitis can be triggered by the penetration of infection into the salivary gland by the hematogenous route in severe infectious diseases (typhoid fever, scarlet fever). Also, some patients were diagnosed with lymphogenous spread of infection from purulent foci, which were localized in the face or neck (boils, purulent wounds, chronic tonsillitis, gum disease, etc.).

Chronic inflammation of the salivary glands is almost always a primary process, that is, it does not occur against the background of acute sialadenitis. This feature is explained by the fact that the salivary glands in a patient with chronic sialoadenitis are initially predisposed to this disease.

Contribute to the development of chronic inflammation of the salivary glands such factors as:

hereditary tendency;
autoimmune diseases;
diseases of internal organs;
psycho-emotional shock;
local or general hypothermia;
trauma;
depletion of the body;
elderly age;
vascular atherosclerosis.

Inflammation of the salivary glands: photos and symptoms

With inflammation of the salivary gland, the symptoms directly depend on which gland is inflamed. Therefore, we propose to consider the signs of inflammation of the salivary glands of different localization.

Inflammation of the parotid salivary gland

In the people, inflammation of the parotid salivary glands caused by the mumps virus is called mumps, since the parotid tissues on the side of the lesion swell, resembling the neck and side of a pig. Mostly mumps occurs in children.

Since mumps is an infectious disease, after infection with the virus there is an incubation period that lasts from 11 to 23 days. Patients in this period do not have any signs of the disease, but, nevertheless, they can already infect others.

At the end of the incubation period in patients with mumps, the following symptoms are observed:

increase in body temperature;
aches in the joints;
muscle pain;
headache;
general weakness;
loss of appetite;
pain in the parotid region and ear;
dry mouth;
swelling of tissues in the parotid region.

Also, the mumps virus can lead to inflammation of the salivary glands under the tongue and under the jaw.

In adults, inflammatory phenomena in epidparotitis are local in nature. The child, except parotid gland, the soft tissues under the chin also become inflamed, making swallowing and chewing painful.

If a child has a painful swelling in the ear area, which is accompanied by symptoms of intoxication, then in no case self-medicate, but immediately consult a pediatrician. Only a specialist can prescribe an effective, and most importantly, safe for child's body treatment.

On palpation, the swelling of the gland is soft and has no clear boundaries.

In rare cases, non-epidemic mumps occurs, which occurs as a result of obstruction of the salivary gland duct by a calculus, a foreign body, or as a result of injury. The causative agent of the disease is mainly pathogenic bacteria that cause purulent inflammation.

Symptoms of non-epidemic parotitis are the same as with viral infection salivary gland. The difference lies in the fact that pus is formed inside the gland, which is released from the duct into the oral cavity.

Inflammation of the sublingual salivary gland

The sublingual salivary gland is located under the tongue and has two ducts that open near the root in the sublingual region.

Most often, the sublingual salivary gland becomes inflamed in patients with tonsillitis, tonsillitis, acute respiratory infections, caries or sinusitis.

With inflammation of the salivary gland under the tongue, patients complain of the following symptoms:

dry mouth or hypersalivation (excess saliva);
pain when chewing;
pain when opening the mouth;
unpleasant taste in the mouth;
taste change;
increase in body temperature.

The sublingual salivary gland produces saliva high content lysozyme, the main function of which is the neutralization of pathogenic microorganisms. Therefore, with inflammation of this gland, the bactericidal properties of saliva are violated, as a result of which patients often develop stomatitis.

Inflammation of the submandibular salivary gland

The submandibular gland has a rounded shape and is located in the submandibular triangle.

In patients with an inflamed submandibular salivary gland, the following symptoms are most often observed:

dry mouth due to decreased salivation;
unpleasant taste in the mouth;
taste change;
bad breath;
pain under the jaw, which increases in the process of chewing food or when opening the mouth;
redness of the mucous membrane under the tongue;
stomatitis;
increase in body temperature;
general weakness;
decrease in working capacity;
loss of appetite.

Diagnosis of sialadenitis

If we talk about what diagnostic methods are used for inflammation of the salivary glands, then the most common and informative are sialography and ultrasound procedure.

In the acute course of the disease experienced specialist there will be enough patient complaints and objective data that can be obtained during examination and palpation of the gland. To clarify the prevalence of the process or differential diagnosis, ultrasound, computed or magnetic resonance imaging can be used.

With sialoadenitis with a chronic course, sialography is performed, the essence of which is the introduction of contrast into the duct of the gland and the performance of an x-ray. In this study, signs of inflammation of the salivary gland may be narrowing of the ducts, the presence of stones or cysts.

How to treat inflammation of the salivary gland?

With inflammation of the salivary glands, treatment directly depends on the course, the cause of the disease and the presence of complications.

In the acute course of sialoadenitis, patients are most often referred to hospital treatment to the hospital. It should also be noted that uncomplicated inflammation of the salivary glands is treated using conservative methods, but with the development of purulent complications, surgery will be required.

In acute nonspecific sialadenitis in the treatment, specialists are guided by the following principles:

diet. Therapeutic nutrition consists in the fact that patients are advised to consume foods that increase salivation. These products include sauerkraut, crackers, cranberry, lemon;
the appointment of a 1% solution of hydrochloric acid pilocarpine, which is taken orally 4-5 drops. This drug helps to reduce the smooth muscles of the duct of the salivary glands, which also increases salivation;
antibiotic therapy. The use of antibiotics for inflammation of the salivary glands is indicated if the disease is bacterial in nature. The drug of choice in this case may be Penicillin or Gentamicin, which is injected directly into the duct of the salivary gland, and in severe cases, it is taken orally or parenterally. Antiseptics are also used, such as Dioxidin and potassium furaginate, which wash the ducts of the glands;
physiotherapy. In the treatment of sialoadenitis, UHF and electrophoresis can be used;
novocaine-penicillin blockade. This procedure effectively eliminates edema and inflammation in the area of the gland and surrounding tissues;
local therapy. Locally used compresses with a 30% solution of dimexide, which are applied to parotid region once a day for 20-30 minutes. This procedure is used only when the parotid salivary gland is inflamed.

With suppuration of the salivary gland, an abscess is opened and drained. Patients with a gangrenous form of sialoadenitis are shown to have a complete removal of the gland.

In acute epidparotitis, all patients must be prescribed etiotropic therapy using antiviral drugs (Viferon, Laferon, Interferon and others). Antipyretic, analgesic and anti-inflammatory drugs (Ibuprofen, Paracetamol, Nimesulide and others) are used as symptomatic therapy.

Exacerbation of chronic inflammation of the salivary glands is also treated according to the principles described above.

During the period of remission, patients with chronic sialadenitis may be prescribed the following procedures:

massage of the ducts of the salivary gland;
the introduction of antibiotics into the duct of the gland;
novocaine blockade in the region of the gland;
electrophoresis with galantamine;
galvanization;
injections into the gland area of Iodolipol 3-4 times a year;
diet.

It is also important to follow the rules of oral hygiene (brush your teeth twice a day, rinse your mouth after meals, use dental floss, etc.).

At frequent relapses an operation is indicated, during which the affected salivary gland is removed, since it is almost impossible to cure chronic sialadenitis conservatively.

Folk methods of treatment

Alternative methods are not effective enough to completely cope with the inflammation of the salivary glands, therefore, they can only be used as a supplement to traditional therapy. Before using any of the methods described below, you should consult with your doctor.

Treatment at home can be carried out using compresses, ointments, infusions, tinctures and decoctions prepared on the basis of natural ingredients. To your attention the most effective and safe folk remedies for the treatment of sialadenitis.

Compress with tincture of celandine and yarrow. One glass of crushed celandine roots and 5 tablespoons of flowers must be passed through a meat grinder, then poured with three glasses of high-quality vodka and let it brew for 7 days in a dark, cool place. A piece of gauze folded in 5-6 layers is soaked in tincture, placed on the parotid area, covered with wax paper and left for 15-20 minutes. The procedure is carried out once a day.
Ointment based on birch tar. One tablespoon of petroleum jelly is thoroughly mixed with ten tablespoons of tar until a homogeneous consistency is formed. The finished ointment is applied to the skin over the affected gland twice a day.
Propolis and. With inflammation of the sublingual salivary gland, a pea-sized piece is placed under the tongue three times a day. The course of treatment is 6 weeks, after which three times a day for one month you need to chew and swallow ½ teaspoon of propolis.
Rinse mouth with solution baking soda. In 200 ml warm boiled water you need to dilute one tablespoon of baking soda. Rinse the mouth with the resulting solution 2-3 times a day.
Echinacea tincture. This medicine can be purchased at a pharmacy. Take tincture three times a day, 30 drops for one month. Also, this natural medicine can be used for compresses.

We have analyzed what constitutes inflammation of the salivary glands, symptoms and treatment in humans, but pets can also get sick with this disease. Therefore, we propose to briefly consider how sialoadenitis proceeds in dogs and cats.

Inflammation of the salivary gland in dogs and cats: causes, symptoms and treatment

The salivary glands in dogs and cats can become inflamed for several reasons, namely:

mechanical injury;
penetration of pathogenic microorganisms into the gland;
poisoning with various poisons.

The disease can also be acute or chronic.

You can suspect sialadenitis in a pet by the following symptoms:

dense swelling in the region of the posterior edge of the lower jaw;
local hyperthermia in the affected area of the salivary gland;
when probing the affected gland, the animal feels pain, so be careful, otherwise the pet will bite you;
the secretion of saliva is sharply reduced or completely absent;
the animal cannot move its head in full, as this is prevented by swelling and soreness of the tissues;
the animal has a reduced appetite, or it completely refuses to eat;
fever;
the ear from the side of inflammation is displaced down;
palpable cervical lymph nodes;
after opening the abscess, there is a release of pus with an unpleasant odor from the fistulas;
with inflammation of the sublingual and submandibular salivary glands in the animal, the tongue increases and thickens, which disrupts swallowing, chewing, and hypersalivation is also present.

In the treatment of sialadenitis in dogs and cats, alcohol compresses, blockades with novocaine, antibiotic therapy, UHF, electrophoresis, ointments are used. With the formation of abscesses, opening, drainage and washing with antiseptics are shown.

An untimely appeal to a veterinarian with inflammation of the salivary glands in cats and dogs threatens to form scars, which make it difficult to move the head, as well as hearing loss.

(cholangitis) and angiocholitis (angiocholitis), which are synonyms.

The name "angiocholitis" is usually associated with inflammation of the intrahepatic biliary tract, up to the bile capillaries (capillary or precapillary angiocholitis), while the term "cholangitis" is preferred to denote inflammation of larger ducts, including extrahepatic ones. Such a division is very conditional. In pathogenetic terms, with any source of cholangitis, the bile ducts of both orders are involved in the process, although to a different extent, and it is rarely possible to localize the process in the area of its distribution. Therefore, both terms are often used as synonyms, replacing one with the other without much reason; sometimes this leads to misunderstandings in understanding the process.

The term "cholangitis" is built more correctly (inflammation of the gall vessel), and the phrase "angiocholitis" does not quite allow exact decoding (« vascular inflammation bile"). Therefore, it is more correct to keep one designation for any inflammation of the biliary tract - “cholangitis”, detailing its nature with a clarifying adjective.

Causes of inflammation of the bile ducts

Cholangitis is most often a complication of the inflammatory process of the gallbladder, but there are cholangitis that occur even in the absence of inflammation in the latter. Among other reasons, the source of such inflammation of the bile ducts can be breakthroughs of an abscess or festering echinococcus of the liver into the bile ducts.

The cause of cholangitis can be various infectious diseases (purulent-septic processes), in which microbes enter the bile ducts by hematogenous and lymphogenous routes.

In surgical practice, inflammation of the bile ducts is more common, having the same cause as cholecystitis; inflammation of the ducts in these cases is usually a complication and accompanies gallbladder disease. Therefore, cholangitis is observed in patients with long-term inflammation of the gallbladder, and often recur.

Recurrent cholangitis can be observed even when removed primary focus- gallbladder, but the running inflammatory process in the bile ducts has not been eliminated.

By existing classification inflammation of the bile ducts are divided into acute (catarrhal and purulent-destructive) and chronic.

With catarrhal cholangitis, the mucosa of the ducts is observed, mucopurulent discharge - turbid bile (desquamation of the epithelium and cell infiltration of the walls of the biliary tract). With timely therapy and elimination of the inflammatory process, such forms of cholangitis can give a lasting recovery. Sometimes these forms of cholangitis become protracted, occur chronically with periodic exacerbations and are referred to as cholangitis lenta.

Destructive - purulent, a form of inflammation of the bile ducts is observed much more often. Purulent cholangitis as a complication of the inflammatory process of the gallbladder is acute and severe. With this form, there is significant hyperemia and thickening (infiltration) of the mucosa of the ducts, the bile is purulent, thick, reminiscent of putty, sometimes clogging the bile ducts. Violation of the outflow of infected bile is the cause of the spread of infection from the extrarenal ducts to the intrahepatic ones and the transition of the infection to the liver parenchyma, followed by the development of abscesses and liver abscesses.

Symptoms of inflammation of the bile ducts

The clinical picture of purulent cholangitis is very characteristic. In most cases, these patients have severe intoxication: general weakness, lack of appetite, subicteric color. skin and mucous membranes.

The icteric coloration of the integument can reach the degree of pronounced jaundice, which, in fact, with cholangitis is parenchymal in nature. The development of obstructive jaundice usually does not depend on the cholangitis itself, but on the disease, the complication of which was cholangitis (stones in the bile ducts, purulent cholecystitis), and vice versa, long-term recurrent cholangitis can lead to cicatricial strictures of the bile ducts, resulting in obstructive jaundice .

A relapsing-type fever is accompanied by chills and profuse sweating and exhausts the sick. The pulse is frequent weak content. Constant dull pain in the hypochondrium, radiating to the right half of the back. Pains sometimes amplify, but do not accept paroxysmal character. These pains are accompanied by heaviness in the hypochondrium. The tongue is dry, furred, the liver is enlarged by palpation, painful, soft consistency. When tapping on the costal arch - a sharp pain.

With chronic inflammation of the bile ducts, the liver can also be enlarged, but its consistency is relatively dense and it is less painful.

To clarify the diagnosis of purulent cholangitis, additional laboratory research. When analyzing blood, high leukocytosis, a shift to the left are established; often there is a decrease in the amount of hemoglobin and erythrocytes.

In a biochemical blood test, significant changes can be detected: an increase in direct bilirubin, a decrease in the content of prothrombin in the blood plasma, and other indicators of oppression of liver functions.

When duodenal sounding, as a rule, inflammatory signs are found in portion C.

Treatment of inflammation of the bile ducts

Catarrhal cholangitis without prolonged chronic nature can be treated conservatively. A great advantage here is the repeated pumping of bile with a duodenal probe (10 lavages per course at intervals of 2-3 days). At the same time, when indicated, patients should be prescribed sulfonamides, diet, heat and antispasmodics. Such conservative therapy is sometimes applicable for chronic cholangitis.

With long-term recurrent cholangitis, cicatricial narrowing of both the extrahepatic ducts and the sphincter of Oddi is possible. In such cases, only surgical intervention is indicated - the imposition of bypass anastomoses.

Conservative therapy for purulent destructive cholangitis is ineffective. AT best case acute process goes into the chronic stage. The method of choice for the treatment of purulent inflammation of the bile ducts is an operation that provides a free outflow of purulent bile. For this, choledochotomy is performed, followed by the common bile duct of Vishnevsky.

In elderly people with a general serious condition, if there is free emptying of the gallbladder (i.e., a passable cystic duct), cholecystostomy may be performed.

In addition to surgery, these patients need the use of restorative and anti-toxic agents: cardiac, the introduction of fluids - saline, glucose, transfusion of plasma, blood; antibiotics, intravenous administration hemolyzed blood.

With such complex treatment inflammation of the bile ducts, satisfactory and fairly stable results can be achieved.

The article was prepared and edited by: surgeon

Salivary glands in humans are not so few. Two parotid (one at each ear), two submandibular (on each side under the lower edge of the jaw) and two sublingual. In addition, there are many different small glands in the sky, cheeks, tongue, lips, mucous and submucosal of the mouth.

And each of these salivary glands one far from perfect day can become inflamed, bringing a lot of trouble to its owner. This condition will be called sialadenitis. A special case of inflammation of the parotid salivary gland is called parotitis. We will talk about inflammation of the salivary glands, symptoms and treatment of sialadenitis further.

Why do they get inflamed

The culprits inflammatory changes most often become:

When an infectious agent enters the salivary gland, the mucosa swells, the duct that excretes saliva narrows, a clear or purulent fluid accumulates in it, and salivation becomes difficult. With the continued existence of such a situation, the gland gradually atrophies or scars, ceasing to produce and secrete enough saliva.

The infection most often penetrates through the mouth of the duct, less often with the flow of blood, lymph:

on the background respiratory infections pharynx, trachea, periodontitis, skin boils
or by contact from nearby areas (with purulent diffuse inflammation of soft tissues).

The causes of inflammation of the salivary glands in 30% of cases are mumps viruses (or mumps).
In addition to the infectious process, gland damage can be included in the program of rheumatic diseases (Sjögren's syndrome)
and radiation damage.
Up to 40% of all inflammations are due to dentistry.

Acute sialadenitis is often infectious.

Chronic inflammation involves the gland tissue itself (parenchymal), its connective capsule (interstitial) or duct in the process. In this case, the disease lasts more than 3 months with periods of peak and remission of inflammation.

What can be seen

The acute process is characterized by the following manifestations:

Edema appears at the location of the inflamed gland,
It is painful and tight when pressed.
If you massage the gland, pus may be released from its duct.
The mouth dries out due to a small amount of saliva, or vice versa, saliva flows all the time.
The temperature may rise.

The pain that the patient feels is located in the projection of the affected gland, can be given to the ear, neck, lower jaw, oral cavity (damage to the submandibular salivary glands). They are oppressive, bursting in nature.

Factors contributing to sialadenitis:

dehydration,
high calcium content in the blood (stones of the ducts of the glands can form, clogging them).

The chronic form of the disease often leads to scarring and atrophy of the glandular tissue, due to which the production of saliva drops significantly, swallowing and speech become difficult.

Interstitial sialadenitis is characterized by painless swelling of the gland. They are more likely to affect people over 40 with immunity errors (diabetes mellitus, hypothyroidism). At the beginning of the process (the process is often symmetrical), the glands are densely elastic, then they become denser. Dry mouth may appear, a drop in efficiency. In exacerbation, pain appears, aggravated by cold.
The parenchymal variant is more often congenital. There is also periodic swelling, salivation with an admixture of pus, with a gradual drop in the level of saliva production.
The ductal variant develops both against the background of a wider congenital duct, and as a result of its acquired expansion (in trumpeters, glassblowers), usually in old age. Do not discount the foreign bodies in the duct, which often give symptoms of inflammation of the submandibular salivary gland. Usually the disease begins suddenly with bursting pain and its increase, more often after eating. When pressed, a secret is released. When the bacterial flora is attached, the temperature rises, swelling increases, and pus is released.

The most formidable complication of such a pathology is abscess formation (the formation of a limited abscess at the site of the gland) and sepsis.

Under this spiritual name, acute inflammation of the parotid salivary gland (mumps) occurs. The disease is caused by a virus transmitted by airborne droplets from a person who is contagious up to the ninth day from the onset of the disease. Children and unvaccinated adults are more likely to get sick. Since the virus has an affinity for glandular tissue, other salivary glands can also be affected, as well as the pancreas and testicles in men or boys, and the ovaries in women.

The virus does not tolerate the environment well, is sensitive to antiseptics and ultraviolet radiation, but tolerates low temperatures and freezing. After the introduction of its RNA into the cells of an infected person, about 18 days pass before the development of the clinic.

Symptoms of unilateral inflammation of the salivary gland: swelling, pain near the ear, salivation, muscle and headaches, fever.

Diagnostic search

With complaints to children, a pediatrician is called, adults themselves come to a therapist, an infectious disease specialist, a dentist, less often a surgeon or a venereologist.

The diagnosis is suspected on the basis of complaints, examination, palpation of the gland.

Ultrasound and radiography are methods for visualizing the glands.
To clarify the nature of inflammation, serological blood tests are performed (if a viral infection is suspected): looking for immunoglobulins to virus antigens. For example, with parotitis, during the incubation period, immunoglobulins may not yet be present or their titer is low (repeat the analysis after a couple of days). From the moment the symptoms appear, there are immunoglobulins M in the blood, with an advanced disease - M and G. After its resolution - G (they also provide immunity after the illness).
For bacterial and viral infections universal way diagnostics with maximum sensitivity remains polymerase chain reaction(for blood or secreted glands). It can also be used as an express diagnostic.
Bacterial agents make it possible to perform a more complex and time-consuming culture of the separated gland with the growth of bacterial colonies and the determination of their sensitivity to antibiotics.
A biopsy may be required in cases of suspicion of an autoimmune process or for differential diagnosis.

How to treat

The patient is placed in protective mode. Treatment of inflammation of the salivary glands at the initial stage is outpatient. Shown milk-vegetarian diet, drinking plenty of water, rinsing the mouth with acidified (lemon juice) solutions or Kaposol.

Local treatment options:
- With mumps - warming alcohol compresses on the parotid region, a blue lamp (sollux), in a polyclinic - UHF, electrophoresis.
- In case of inflammation of the glands of the oral cavity - rinsing with antiseptics (Miramistin, Furacillin solution: 2 tablets per glass of water), baking soda solutions: a teaspoon per glass of water.
Antiviral drugs are used more often for mumps, but their effectiveness is poorly proven today.
If carried out antibiotic treatment, what antibiotics to choose? The choice is based on the high resistance of the oral flora to antibiotics. The first-line drugs are Amoxicillin (Ospamox, Amosin) and Amoxicillin clavulanate (Amoxiclav, Flemoclav, Augmentin), the second is Cefixime (Zinnat, Suprax) or Josamycin (Vilprafen).
Paracetamol, Ibuprofen (up to three times a day) can be used to reduce pain, intoxication and fever.
A chronic process in the acute stage requires antimicrobial therapy, anesthesia. In the stage of remission - resolving therapy or replacement of saliva deficiency (rinsing with Kaposol). The same tactics are followed for Sjögren's syndrome and radiation damage to the glands.
The surgical stage may be required for suppuration of the glands, duct stones. Stones can be removed during duct bougienage, lithotripsy, lithoextraction.

Prevention

For mumps - vaccinations in childhood, non-specific quarantine measures in children's groups during epidemics, sanitization premises, personal protective measures for healthy adults caring for the sick (masks, hand washing).

It is also worth paying attention to the state of the immune response (eat well, correct hormonal pathologies, do not take uncontrolled drugs that reduce immunity, beware of radiation).

Paradoxically, barrier contraceptive measures (condoms, latex wipes) protect against specific inflammation of the salivary glands against the background of genital infections.

Timely and preventive visits to the dentist, adequate care of the teeth and oral cavity prevents the development of odentogenic sialadenitis.

Treatment of the inflammatory process in the salivary gland - an overview of methods

Swelling in the maxillofacial or cervical region can be a sign of such an insidious disease as sialadenitis - an inflammation of the salivary gland, the treatment of which is so variable that it is quite difficult for a non-specialist to figure out all the possible ways on their own.

So, what is the treatment of sialadenitis, read on.

Symptomatic treatment

If sialoadenitis occurs in a mild primary or chronic form, then, as a rule, to eliminate it, it is enough to stop the inflammatory process with drugs, rinse your mouth with saturated soda (saline) solution and regularly massage the affected area to increase salivation.

Symptomatic treatment performs several important functions:

eliminates congestion and swelling in the glands;
stimulates the movement of lymph and blood in the affected area;
reduces the effects of intoxication of the body;
relieves pain.

Treatment of symptoms does not always help: very often inflammation of the salivary glands develops against the background of serious viral, infectious or fungal diseases, in this case it is necessary to act on the problem in a complex manner, eliminating not only the consequences, but also the very cause of the pathology.

Dieting

To prevent blockage of the salivary glands and prevent their re-inflammation, during the treatment period and for some time (depending on the body's regenerative capabilities) after the symptoms have been eliminated, the doctor may recommend a special diet that will stimulate a constant outflow of saliva.

Basic rules of the salivary diet:

it is necessary to dissolve a small slice of lemon before each meal, which, depending on individual preferences, can be replaced with other natural food that has a pronounced sour taste (sauerkraut, cranberries, lime);
for a while, stop using foods that can cause mechanical (nuts, seeds, bony fish, shell seafood, meat with small bones, waffles, cookies) or chemical (vinegar, artificial colors, stabilizers, etc.) injuries to the oral mucosa ;
include in the daily diet fruits and vegetables (paprika, cabbage, kiwi, rose hips, currants, pears), rich in vitamin C, which is useful for local and general immunity of the body;
be sure to rinse your mouth with a weakly concentrated one (1 tsp of soda per 200 ml warm water) soda solution after each meal to neutralize the remaining acids and disinfect the oral cavity;
if it is difficult or painful for the patient to swallow, then when compiling the menu, food with a softer texture (cereals, soups, mashed potatoes, stewed vegetables or any other finely chopped dishes) should be preferred.

Such a diet avoids stagnation of saliva in the glands and helps to remove dead cells and bacteria from them.

If there is an urgent need to increase salivary outflow, and the diet does not help, then the doctor prescribes a course of drugs that stimulate salivation (saliva production), for example, a 1% solution of pilocarpine hydrochloride (4-5 times a day, 5-6 drops).

Rinsing with antiseptics

For rinsing the throat and mouth, agents with antimicrobial and anti-inflammatory properties are used, which can be safely used to treat the skin and mucous membranes:

Chlorhexidine solution 0.05-0.1% - does not require dilution with water;
Furacilin 20 mg tablets - 2 tablets (40 mg) per 200 ml of water;
water tincture of calendula 10% - 20 ml of tincture per 250 ml of water;
Septisol (concentrate) - 5 ml of solution per 250 ml of water;
alcohol tincture of propolis 10% - 10 ml of tincture per 200 ml of water.

Procedure rules:

temperature ready solution-38-40°C;
the frequency of rinsing - from 5 to 7 times a day;
liquid retention time in the mouth - at least 30 seconds;
duration of the course - from 5 days or more (if necessary).

In one approach, it is necessary to use up the entire resulting solution, because during storage it loses its medicinal properties. Improvement with this method of treatment occurs within the first two days. Regardless of the chosen means, any of them, in accordance with the instructions, is forbidden to be swallowed, therefore, the procedures must be carried out with the utmost care.

Due to the impossibility of full control, this method is not recommended for the treatment of children under 6 years of age. If the need to use antiseptics still arises, you can pour the solution into a spray bottle and independently irrigate the affected area of \u200b\u200bthe child in a strictly metered volume.

The use of painkillers

To reduce body temperature (if it exceeds 38.5 ° C) and reduce the intensity of the pain syndrome, it is allowed to take non-steroidal anti-inflammatory drugs (Analgin, Baralgin, Ibuprofen, Pentalgin, Tempalgin), which have antipyretic, analgesic and anti-inflammatory effects.

In severe cases, to stop very severe attacks of pain, which are often accompanied by spasms of the salivary ducts, a temporary shutdown of innervation (sensitivity of nerve endings) in the affected area of the face or neck can be shown by novocaine blockade. This procedure is carried out only in a hospital setting.

The use of antihistamines (Suprastin, Loratadin) is required in the event of a concomitant allergic reaction: additional edema in this situation can lead to serious consequences, up to the onset of involuntary asphyxia (suffocation).

Physiotherapy

Physiotherapeutic methods of treatment are used in parallel with drug therapy.

Local hardware impact on the neck and maxillofacial zone is aimed at eliminating the very cause of the development of sialoadenitis and restoring the functional activity of the affected gland.

Physiotherapy can be prescribed even in the acute phase of the disease, if at the same time the possibility of the natural passage of saliva through the excretory duct is preserved.

The physiotherapy treatment plan for sialadenitis includes three stages:

elimination of the focus of inflammation;
removal of edema from tissues;
reduction of pain sensations.

The most effective anti-inflammatory treatments:

UV therapy - irradiation of the affected area with an ultraviolet lamp is carried out in a course of 4 to 5 procedures every two days;
fluctuorization - the course of therapeutic effects of pulsed current on the gland is 8-10 daily sessions.

Ways to eliminate pathological infiltration (accumulation biological fluid) and relieve puffiness:

IR therapy - complete resorption of a liquid formation takes at least 12 procedures;
Ultrasound therapy - daily ultrasound treatment continues for 1 to 2 weeks;
electrophoresis - this method of drug delivery (potassium iodide 3%) into the deep layers of the skin can be used up to 10-12 days in a row.

The option (focused or defocused) of radiation exposure is selected individually in each case, the course is from 8 to 10 daily sessions.

The advantage of the laser method is that in addition it also has an anti-allergic effect: this allows you to exclude or limit the use of antihistamines.

Compresses with Dimexide

Dimethyl sulfoxide (Dimexide) is a widely used medicine with anti-inflammatory and analgesic action.

With sialadenitis, it is used in the form of local applications (compresses) to relieve spasm of the salivary gland duct, eliminate the inflammatory process and reduce pain.

Warm gauze compresses with a 30% solution of Dimexide should be applied to the affected gland from the outside for 30-40 minutes. This procedure can be repeated no more than twice a day.

With this treatment regimen, the drug penetrates well deep into the skin, where it reaches the focus of inflammation and affects the microbial flora, helping to cope with pain.

Antibacterial therapy, antiviral and antifungal drugs

Traditional conservative treatment involves eliminating the root cause of sialoadenitis by taking medications, the choice of which depends on the type of pathogen:

antibacterial drugs, including antibiotics (Azithromycin, Norfloxacin, Cifran, Oxacillin) - are prescribed to destroy pathogenic microorganisms if an infection has become the cause of inflammation;
antiviral drugs (Interferon, Kagocel, Amiksin, Arbidol) - are used in case of development of pathology of the salivary glands against the background of a decrease in immunity during viral infection;
antifungal agents (Levorin, Pimafucin, Mycozoral, Fluconazole) - have antimycotic properties that suppress mycoses (fungal lesions) and clear the salivary ducts from them, restoring normal patency.

If a positive effect is observed from taking prescribed medications, but it is not enough for a full recovery, then antibiotics (Penicillin, Gentamicin) and antiseptics (Dioxidin, potassium furaginate) are additionally injected into the inflamed duct directly through the catheter.

If this does not give the expected result within the next 2-3 days, then the patient is placed under the supervision of doctors in a hospital and a dropper is installed with the addition of Kontrykal or Atropine, which quickly relieves swelling and inflammation. After that (depending on the situation), doctors decide whether to continue conservative treatment or transfer the patient to the surgical department.

Surgery

Surgery is the most last resort the fight against sialoadenitis, which is prescribed only in emergency situations:

complete absence of positive dynamics with conservative treatment for 5-7 days;
the threat of rupture of the gland due to the very large volume of pus accumulated in it;
deposition of large stones in the parenchyma of the salivary glands or in their ducts (extensive calculosis);
necrotic process in the gland or adjacent area (gangrenous form of the disease);
chronic severe inflammation.

In the conditions of a surgical hospital, an opening of the festering cavity of the salivary gland with its outer side, after which it is drained (dehydrated) by installing a catheter. In this case, directly into the affected organ are introduced antibacterial drugs, which will prevent the further spread of infection throughout the body and will not allow pus to re-accumulate in the gland itself.

Operational removal stones at calculous form inflammation is necessary only in the case of the formation of large solid formations that cause a regular exacerbation of sialadenitis.

If they have an unformed appearance, a loose structure, a high degree of fragmentation (dispersion), then in this case the treatment is observational in nature, since there is a high probability of dissolution of small particles spontaneously or under the influence of medications.

In the presence of several large stones, the damaged salivary gland must be completely removed.

The gangrenous form of the disease is the basis for urgent hospitalization and carrying out an unscheduled operation, since such a condition is a direct threat to the life of the patient. Excision of dead tissue is carried out through an external incision under general anesthesia.

A safer alternative is cryotherapy. Exposure to cold inhibits the development of the inflammatory process and enhances the swallowing reflex, which allows you to restore the function of the natural outflow of saliva.

In order not to face the need for a long and difficult treatment sialadenitis, it is necessary to control the condition of the oral cavity: compliance with the rules of personal hygiene, timely elimination of dental problems, prevention of viral and infectious diseases in most cases can avoid inflammation of the salivary gland or, in case of illness, do without surgical intervention.

Why the cheek is swollen, or inflammation of the salivary glands: how to diagnose and treat?

Inflammation of the salivary gland in medicine is called sialoadenitis and is a disease of the salivary glands of an inflammatory nature with an acute or chronic course. Most often, the parotid salivary glands are affected by the inflammatory process.

Sialoadenitis is equally common in both adults and children. Also, the incidence of this disease is at the same level in men and women.

Inflammation of the salivary glands: causes

In acute inflammation of the salivary glands, the cause is almost always the penetration of pathogenic microorganisms into the gland. Depending on the type of pathogen, the following forms of acute sialadenitis are distinguished:

viral etiology, which is most often caused by the mumps virus, since this virus is tropic to the glandular epithelium. The main route of transmission of the disease is airborne. The entrance gates in this case are the mucous membranes of the mouth and throat. The reproduction of the virus occurs in the glandular epithelium of the parotid salivary gland. In boys, there is also glandular tissue in the testicles, to which the mumps virus is tropic, so they can also be affected, which in some cases leads to infertility;
bacterial etiology. This form of sialadenitis develops both with exogenous and endogenous penetration of bacteria into the salivary glands.

Basically, the causative agents of acute sialadenitis are representatives of the normal microflora of the oral cavity. The following factors contribute to the development of the inflammatory process:

non-compliance with oral hygiene;
reactive narrowing of the ducts of the salivary glands. This condition occurs against the background of general exhaustion of the body due to extensive surgical interventions on the abdominal organs, cancer intoxication, chronic diseases of the digestive tract, stress, diet errors or diabetes mellitus. The narrowing of the duct of the salivary gland leads to stagnation of saliva, which creates fertile ground for the life and reproduction of pathogenic microbes;
obstruction of the duct of the salivary gland. Obstruction of the duct is most often carried out by a calculus or a foreign body. In this case, the outflow of saliva from the gland is also disturbed, and optimal conditions are created for the reproduction of pathogenic bacteria.

In addition, acute sialoadenitis can be triggered by the penetration of infection into the salivary gland by the hematogenous route in severe infectious diseases (typhoid fever, scarlet fever). Also, some patients were diagnosed with lymphogenous spread of infection from purulent foci, which were localized in the face or neck (boils, purulent wounds, chronic tonsillitis, inflammation of the gums, and others).

Contribute to the development of chronic inflammation of the salivary glands such factors as:

hereditary tendency;
autoimmune diseases;
diseases of internal organs;
psycho-emotional shock;
local or general hypothermia;
trauma;
depletion of the body;
elderly age;
vascular atherosclerosis.

Inflammation of the salivary glands: photos and symptoms

Inflammation of the parotid salivary gland

At the end of the incubation period in patients with mumps, the following symptoms are observed:

increase in body temperature;
aches in the joints;
muscle pain;
headache;
general weakness;
loss of appetite;
pain in the parotid region and ear;
dry mouth;
swelling of tissues in the parotid region.

Also, the mumps virus can lead to inflammation of the salivary glands under the tongue and under the jaw.

In adults, inflammatory phenomena in epidparotitis are local in nature. In a child, in addition to the parotid gland, the soft tissues under the chin also become inflamed, which makes swallowing and chewing painful.

On palpation, the swelling of the gland is soft and has no clear boundaries.

Symptoms of non-epidemic parotitis are the same as with a viral infection of the salivary gland. The difference lies in the fact that pus is formed inside the gland, which is released from the duct into the oral cavity.

Inflammation of the sublingual salivary gland

The sublingual salivary gland is located under the tongue and has two ducts that open near the root in the sublingual region.

Most often, the sublingual salivary gland becomes inflamed in patients with tonsillitis, tonsillitis, acute respiratory infections, stomatitis, caries or sinusitis.

With inflammation of the salivary gland under the tongue, patients complain of the following symptoms:

dry mouth or hypersalivation (excess saliva);
pain when chewing;
pain when opening the mouth;
unpleasant taste in the mouth;
taste change;
increase in body temperature.

Inflammation of the submandibular salivary gland

The submandibular gland has a rounded shape and is located in the submandibular triangle.

In patients with an inflamed submandibular salivary gland, the following symptoms are most often observed:

dry mouth due to decreased salivation;
unpleasant taste in the mouth;
taste change;
bad breath;
pain under the jaw, which increases in the process of chewing food or when opening the mouth;
redness of the mucous membrane under the tongue;
stomatitis;
increase in body temperature;
general weakness;
decrease in working capacity;
loss of appetite.

Diagnosis of sialadenitis

If we talk about what diagnostic methods are used for inflammation of the salivary glands, then the most common and informative are sialography and ultrasound.

In the acute course of the disease, an experienced specialist will have enough complaints from the patient and objective data that can be obtained during examination and palpation of the gland. To clarify the prevalence of the process or differential diagnosis, ultrasound, computed or magnetic resonance imaging can be used.

How to treat inflammation of the salivary gland?

In the acute course of sialoadenitis, patients are most often referred for inpatient treatment in a hospital. It should also be noted that uncomplicated inflammation of the salivary glands is treated using conservative methods, but with the development of purulent complications, surgery will be required.

In acute nonspecific sialadenitis in the treatment, specialists are guided by the following principles:

diet. Therapeutic nutrition consists in the fact that patients are advised to consume foods that increase salivation. These products include sauerkraut, crackers, cranberries, lemon;
the appointment of a 1% solution of hydrochloric acid pilocarpine, which is taken orally 4-5 drops. This drug helps to reduce the smooth muscles of the duct of the salivary glands, which also increases salivation;
antibiotic therapy. The use of antibiotics for inflammation of the salivary glands is indicated if the disease is bacterial in nature. The drug of choice in this case may be Penicillin or Gentamicin, which is injected directly into the duct of the salivary gland, and in severe cases, it is taken orally or parenterally. Antiseptics are also used, such as Dioxidin and potassium furaginate, which wash the ducts of the glands;
physiotherapy. In the treatment of sialoadenitis, UHF and electrophoresis can be used;
novocaine-penicillin blockade. This procedure effectively eliminates swelling and inflammation in the area of the gland and surrounding tissues;
local therapy. Locally, compresses with a 30% solution of dimexide are used, which are applied to the parotid region once a day for 20-30 minutes. This procedure is used only when the parotid salivary gland is inflamed.

With suppuration of the salivary gland, an abscess is opened and drained. Patients with a gangrenous form of sialoadenitis are shown to have a complete removal of the gland.

Exacerbation of chronic inflammation of the salivary glands is also treated according to the principles described above.

During the period of remission, patients with chronic sialadenitis may be prescribed the following procedures:

massage of the ducts of the salivary gland;
the introduction of antibiotics into the duct of the gland;
novocaine blockade in the region of the gland;
electrophoresis with galantamine;
galvanization;
injections into the gland area of Iodolipol 3-4 times a year;
diet.

It is also important to follow the rules of oral hygiene (brush your teeth twice a day, rinse your mouth after meals, use dental floss, etc.).

With frequent relapses, an operation is indicated, during which the affected salivary gland is removed, since it is almost impossible to cure chronic sialadenitis conservatively.

Folk methods of treatment

Compress with tincture of celandine and yarrow. One glass of crushed celandine roots and 5 tablespoons of flowers must be passed through a meat grinder, then poured with three glasses of high-quality vodka and let it brew for 7 days in a dark, cool place. A piece of gauze folded in 5-6 layers is soaked in tincture, placed on the parotid area, covered with wax paper and left for 15-20 minutes. The procedure is carried out once a day.
Ointment based on birch tar. One tablespoon of petroleum jelly is thoroughly mixed with ten tablespoons of tar until a homogeneous consistency is formed. The finished ointment is applied to the skin over the affected gland twice a day.
Propolis and mummy. In case of inflammation of the sublingual salivary gland, a piece of mummy the size of a pea is placed under the tongue three times a day. The course of treatment is 6 weeks, after which three times a day for one month you need to chew and swallow ½ teaspoon of propolis.
Rinse your mouth with a solution of baking soda. In 200 ml of warm boiled water, you need to dilute one tablespoon of baking soda. Rinse the mouth with the resulting solution 2-3 times a day.
Echinacea tincture. This medicine can be purchased at a pharmacy. Take tincture three times a day, 30 drops for one month. Also, this natural medicine can be used for compresses.

Inflammation of the salivary gland in dogs and cats: causes, symptoms and treatment

The salivary glands in dogs and cats can become inflamed for several reasons, namely:

mechanical injury;
penetration of pathogenic microorganisms into the gland;
poisoning with various poisons.

The disease can also be acute or chronic.

You can suspect sialadenitis in a pet by the following symptoms:

dense swelling in the region of the posterior edge of the lower jaw;
local hyperthermia in the affected area of the salivary gland;
when probing the affected gland, the animal feels pain, so be careful, otherwise the pet will bite you;
the secretion of saliva is sharply reduced or completely absent;
the animal cannot move its head in full, as this is prevented by swelling and soreness of the tissues;
the animal has a reduced appetite, or it completely refuses to eat;
fever;
the ear from the side of inflammation is displaced down;
palpable cervical lymph nodes;
after opening the abscess, there is a release of pus with an unpleasant odor from the fistulas;
with inflammation of the sublingual and submandibular salivary glands in the animal, the tongue increases and thickens, which disrupts swallowing, chewing, and hypersalivation is also present.

An untimely appeal to a veterinarian with inflammation of the salivary glands in cats and dogs threatens to form scars, which make it difficult to move the head, as well as hearing loss.

Inflammation of the salivary gland - symptoms, treatment, photo

All photos from the article

The inflammatory process in the salivary gland, usually parotid, occurs in both adults and children. Based on the reasons that caused it, as well as the age of the patient, the course of the disease is accompanied by various symptoms and requires appropriate treatment. The scientific purpose of inflammation of the salivary gland is sialadenitis (in some editions, sialadenitis). The disease rarely affects the submandibular and sublingual glands, in its course it is chronic and acute.

Main reason, inflammatory salivary gland, this is the action of an infectious microenvironment that has entered its cavity. Pathogens are diverse, based on their type, the disease is:

Viral, developing with mumps or in a simple "mumps". This microenvironment is well transmitted through the air and causes high sensitivity of the salivary glands, therefore, when it enters through Airways, the virus quickly penetrates into the parotid gland, begins to multiply in it, which causes inflammation. The pathogen poses an additional threat to children - boys. Since its abundant reproduction can lead to damage to the structure of the testicles, which will be reflected in infertility in adulthood.

Photo 1. Location of the parotid salivary gland

bacterial, otherwise called non-specific. In this case, the microflora is introduced through the oral cavity or by entering it into the blood. The main causes of infection bacterial type sialadenitis is:

Poor oral hygiene
Reactive obturation, when obstruction of the abdominal organs is observed, for example, as a result of surgery, the development of a malignant tumor, diseases of the gastrointestinal tract, stress, malnutrition or susceptibility to diabetes. As a result of obstruction, the ducts narrow reflexively, due to which the volume of saliva secreted decreases and it accumulates at the place of production. All this creates a favorable environment for microorganisms from the oral cavity to take root and begin to multiply in the parotid gland.
Mechanical obturation, when the duct is blocked by a foreign object, such as a calculus. The result here is the same as with reactive blockage - the development of inflammation.

Infection through the blood is a rarer phenomenon, which is facilitated by the disease of typhoid fever and scarlet fever. In addition, sialadenitis can occur when a person has symptoms of pharyngeal inflammation, lesions on the mucous membrane in the mouth, signs of furunculosis, tonsillitis, periodontitis. These pathologies should not be ignored, if they are present, it is important to carry out qualified treatment in order to avoid complications.

Inflammation of the salivary gland is characterized a rare occurrence, when chronic form this is not a sequel to acute. Sialoadenitis is primarily a chronic disease, because. the salivary gland in its structure is prone to a gradual change in the tissue structure. The main reasons why it becomes inflamed in some people and not in others is:

genetic features
Autoimmune abnormalities
Situations of high stress
hypothermia
Getting injured
Weakness of the body against the background of a serious illness

In older adults chronic inflammation more common than in children and young adults. This is due to atherosclerotic phenomena, due to which the blood supply and nutrition of the salivary gland deteriorates. Atherosclerosis occurs as a result of the aging of the body, when the vessels and arteries slowly wear out and lose their tone.

Symptoms and photos

The initial stages of inflammation of the salivary gland are manifested by very acute manifestations, most often in a person, the temperature rises sharply to values over 39 gr. The main external symptom is swelling in the area near the ears, which manifests itself symmetrically, which is accompanied by pain with increased chewing. Gradually, the swelling increases, and the swelling, spreading outward, becomes more expressive. More informative symptoms are presented in the photo.

Photo 2. Inflamed salivary glands in the mouth

With the development of the disease or if adequate treatment is absent, then the disease also moves to the salivary glands under the tongue and lower jaw.

Availability additional symptoms will depend on the type of inflammatory process, while if the disease is not treated, then it goes through several stages in turn:

At serous form of sialadenitis, in addition to swelling in the parotid area, there is dryness in the mouth. Pain sensations tend to increase when eating food or even when looking at it, when saliva is reflexively released. The skin in the parotid zone is not changed, if you press a little on the salivary gland, then there is almost no salivation.

Photo 3. external symptoms inflammation

If there was a transition to purulent stage the pain becomes very severe. A person cannot sleep and eat normally, the temperature is stable, its value is >38 degrees. There are symptoms of restriction when opening the mouth, swelling is noticeable in the temples, cheeks and lower jaw. If you press on the area of swelling, which to the touch has a dense structure with a red skin tone and pain when touched, then a certain volume of purulent contents is released into the oral cavity.

Gangrenous form is very active and pronounced. The main symptoms are high fever, partial lesion skin over the inflamed salivary gland, through which the dead parts of the organ are gradually released.

In some cases, the disease turns into the death of the patient, when the infection spreads uncontrollably, leading to sepsis in different parts of the body. Another reason for death is heavy bleeding arising from damage to the cervical vessels. Thus, despite the small size of the salivary gland, the inflammatory process in it can result in the most serious consequences, so the disease must be treated. At the same time, amateur performance is not allowed, all treatment must take place within the framework of a medical institution.

If it has been inflamed submandibular salivary gland, then swelling occurs at its location. When palpating, an increase in size, tuberosity and severe pain are diagnosed. The progression of the disease causes pain when swallowing due to an increase in the area of edema. In the sublingual zone, redness and signs of swelling are noticeable, pus is sometimes released from the iron ducts.

Disease submandibular glands are often referred to as calculous. "Calculous" means a foreign object that overlaps something. In such conditions, small pebbles can block the salivary ducts. This is usually due to an increase in calcium levels. The calculous inflammatory process has symptoms:

A sharp stabbing sensation of pain that increases when taking food
Impaired salivation
Dryness in the mouth
Swelling and tuberosity in the submandibular area
Purulent discharge from under the tongue
An increase in the volume of the salivary gland during periods of eating, which is expressed by discomfort, and sometimes even does not allow you to eat normally

The sublingual salivary gland becomes inflamed in rare cases, most often it occurs against the background of an abscess or lesions of the teeth.

Chronic sialadenitis

Chronic disease takes many forms.

At chronic interstitial form parotid salivary gland is affected. Pathology is more typical for older people, especially for women. For a long period, any signs and manifestations are absent, as inflammation develops slowly, causing constriction of the ducts along the way.

A sharp increase in symptoms happens suddenly, its first sign is a dry mouth. The gland itself becomes enlarged, becomes painful and smooth to the touch. After the exacerbation has passed, the size of the organ does not return to normal, remaining several times larger.

Chronic parenchymal inflammation almost in all cases concerns exclusively the parotid gland. In women, the risk of development is also higher than in men, there are no pronounced age groups susceptible to the disease, it occurs both in an infant and a very old man over 60-70 years old. Often there are no symptoms at all for many years.

The exacerbation resembles acute sialoadenitis when initial stage only a very large release of salty mucus is diagnosed, if you press on the salivary gland. Without treatment, a feeling of heaviness develops further and increased density glands, there are no symptoms of limited mouth opening. On the late stages the surface becomes bumpy, there are no pain sensations, saliva is secreted with purulent phenomena, sometimes dry mouth is present.

Sialodochit call the state when the pathological process has touched only the ducts that are expanding. The disease is characteristic of both men. So are older women. The main symptom is increased excretion saliva while eating or talking skin surface swells around the mouth. During an exacerbation, the salivary gland swells strongly, pus is released from it.

Diagnostics

Identification of an acute form of inflammation occurs during examination and questioning. Previously practiced sialography, which involves the introduction of a contrast agent. However, later this diagnostic method was abandoned, since during acute course it enhances the inflammatory process, which sharply increases soreness.

Sialography is used in the diagnosis chronic sialadenitis. If the disease is present, then x-ray narrowing of the ducts will be detected and a small amount of contrast. A feature of the parenchymal form is a large number of cavities with a diameter of 6-9 mm, which in total include a large amount of contrast.

Treatment of inflammation of the salivary gland

If the patient has symptoms acute inflammation, the treatment is carried out in a hospital. The main therapy is conservative, surgery is resorted to only in a situation of purulent manifestations.

How to treat acute sialadenitis

At mumps treatment is prescribed based on the symptoms present. Interferon agents are mainly used, and the patient is also shown to be treated with antipyretic and analgesic drugs.

If revealed acute nonspecific inflammation salivary gland, then the treatment is aimed at eliminating the inflammatory reaction and returning the standard functionality of saliva secretion. The main therapy is:

The use of a salivary diet to train the muscular structure of the ducts through which saliva is excreted. Diet products include everything sour, such as lemon, cranberries, and crackers.
The introduction of antibiotics and antiseptics into the cavity of the duct, for example, penicillin and gentamicin, dioxidine and potassium furaginate.
The use of an anti-inflammatory compress based on a Dimexide solution, which anesthetizes and suppresses the progression of the disease.
Physiotherapy using UHF and warming.
Blockades based on novocaine and penicillin with severe edema and a sharp increase in inflammation.
Taking systemic antibiotics. Which antibiotics to choose the doctor decides after studying the bacterial environment.
Intravenous injections.

Surgery as a treatment is used in the purulent course of the disease. The gangrenous course is the most severe, it requires an urgent operation under general anesthesia. If the cause of the pathology is a calculus, then it must be removed, otherwise relapses will be repeated again.

How is a chronic condition treated?

In exacerbations, treatment is the same as in the acute form. In periods when there is no exacerbation, the chronic form is treated:

Massages of the ducts, when an antibiotic is additionally introduced into their cavity to combat purulent phenomena
Novocaine blockades, electrophoresis, which increase secretion
Daily galvanization course
The introduction of solutions that prevent the development of exacerbations
X-ray therapy, due to which the inflammation of the salivary gland is well stopped
Removal of the gland, the restoration of the functionality of which is impossible.

Which doctor treats

Profile doctors who treat sialadenitis are dentist or surgeon specializing in the facial and jaw area. When a person has symptoms of mumps, then for children the profile doctor is a pediatrician, and for adults - a therapist. The task of these broad specialists is to conduct an initial examination and refer them to a narrower doctor, for example, an infectious disease specialist who treats mumps.

Preventive measures

To prevent the occurrence of inflammation of the salivary gland, there are no special preventive measures associated with the introduction of the vaccine. The only exception is mumps, when a special vaccine is used, which is also used to protect against measles and rubella. This method of prevention is used for children, they are vaccinated at the age of about 18 months. The effectiveness of such vaccination is kept at the level of 95% and allows you to almost completely eliminate the occurrence of the disease.

to the standard curative prevention include:

Compliance with oral hygiene
Timely cleansing of infectious foci in the mouth, often associated with caries and other dental lesions
Tracking congestion in salivation and preventing them by taking special medications (pilocarpine), rinsing with furacilin, rivanol and other antiseptics.

Treatment of inflammation of the bile ducts is carried out with drugs and spa methods.

Symptoms of inflammation of the bile ducts

Pain in the right hypochondrium

Enlargement of the liver

nausea and vomiting

As the disease progresses, the spleen may also become enlarged.

On the second or third day, the patient may develop jaundice, which is reflected in the change in the color of the skin and the color of the sclera. Also characterized by pruritus

Symptoms of inflammation of the bile ducts in purulent cholangitis

If purulent inflammation is observed, then the disease is more pronounced. An obligatory phenomenon is a sharp rise in temperature to 40 degrees. In severe cases, the disease can lead to the development of hepatitis, sepsis, and even hepatic coma.

The diagnosis of "Inflammation of the bile ducts" is made on the basis of a characteristic clinical picture. Laboratory data provide additional data to clarify the patient's condition.

In the presence of a sharp inflammation in the blood is noted

an increase in the number of leukocytes,
increase in ESR,
as well as changes in indicators of biochemical analysis.

used to accurately diagnose inflammation.

cholangiography,
retrograde cholangiography,
gastroduadenoskopiya,
in rare cases, laparoscopy.

Symptoms of inflammation of the bile ducts of different types

acute,
sclerosing
and chronic.

The most common form of duct inflammation is chronic cholangitis. Its development is promoted by chronic cholecystitis, cholelithiasis and other diseases of the biliary tract. In the vast majority of cases, the manifestations of chronic cholangitis are almost invisible. Most often, patients have a great fatigue, a slight increase in temperature. In the right hypochondrium, a dull pain may occur, or a bursting or squeezing can be felt.

Treatment of inflammation of the bile ducts

For therapy use:

Antibacterial treatment of inflammation, broad-spectrum antibiotics are preferred.

treatment of inflammation with choleretic drugs

In the stage of remission, the spa treatment of inflammation of the bile ducts has a positive effect.

Why does bile duct inflammation occur?

cicatricial narrowing of the bile ducts and their outlets;

damage to the mucous membrane of the biliary tract stones;

symptoms of inflammation are caused by blockage of the biliary tract by helminths

with a combination of stagnation of bile with a violation of the mucous membrane, inflammation of the bile ducts is caused by enterococci, staphylococci, Escherichia coli.

Cholangitis: symptoms, diagnosis, classification, treatment and causes of the disease

Cholangitis (cholangitis) -infection bile ducts. It occurs due to a bacterial infection. Allocate acute and chronic form. Sometimes develops as independent disease, more often it is a consequence of other diseases of the internal organs. It usually occurs in older women. This article will tell you what cholangitis is, what the symptoms are, and how to treat it in adults.

Elevated temperature always accompanies the acute form of the disease. Intense pain on the right side of the ribs. According to the area of \u200b\u200bthe inflammatory process, cholangitis is divided into:

With swelling of the mucous membrane of the bile ducts, which leads to their narrowing, cholangitis is called catarrhal.
The purulent form of cholangitis is very severe, with the release of pus and filling the ducts with it. The liver and gallbladder can also be affected. Cholangitis of the gallbladder may occur, the diagnosis and causes are the same as with other types of disease.
In necrotizing cholangitis, hormones and digestive enzymes pancreas getting into the bile ducts, affect the mucous membrane and contribute to its death.
In diphtheritic cholangitis, the mucous membrane of the bile ducts is affected by ulcers, the mucosa begins to die, the bile ducts are destroyed from the inside and affect other organs. In this case, the liver suffers first of all, and liver cholangitis may develop, the diagnosis and causes are the same as with gallbladder cholangitis.

Chronic cholangitis

The chronic form of the disease can proceed secretly, at first without special symptoms, for many years. It happens that the acute form, without proper treatment, becomes chronic.

Sclerosing cholangitis is an autoimmune disease and occurs due to immune disorders in the body, without the presence of infection. At the same time, the bile ducts harden and overgrow. The gap in them becomes very narrow and eventually disappears. This causes the development of cirrhosis of the liver. The disease is incurable, can progress for many years and is fatal. This disease is divided into primary and secondary cholangitis.

Diagnosis of primary and secondary cholangitis, what it is and signs of the disease

The causes of this type of cholangitis have not been studied, doctors believe that it is gene disease inherited. It proceeds with the same symptoms as the secondary one, which occurs due to intoxication of the bile ducts:

abdominal pain;
itching in the abdomen;
jaundice;
temperature and general weakness;
weight loss.

Symptoms and signs of cholangitis

The disease in an acute form occurs suddenly. But like any disease, cholangitis also has symptoms and signs:

Very high temperature up to 40 0 С;
Characteristic pains on the right side of the ribs;
Jaundice of the skin and mucous membranes of the eyes;
Chills, heavy sweating;
General intoxication of the body, which is characterized by diarrhea, general weakness, vomiting and loss of appetite;
Due to jaundice, itching of the skin appears;
If the form of the disease is severe, the patient may lose consciousness.

In the chronic form of cholangitis, the symptoms are not so pronounced, the pain is dull, the temperature is low, closer to normal. The patient quickly gets tired, feels general weakness. If the disease is not treated, a number of dangerous complications can appear.

Diagnosis of cholangitis

For the diagnosis of the disease are based:

on the visual inspection sick;
on his complaints;
on the presence of symptoms;
on results various analyzes and ultrasound.

Basic diagnostic methods:

At infectious forms differential diagnosis is needed. Cholangitis in children can also develop, but has a different etiology.

Treatment of cholangitis

With cholangitis, it is better to undergo treatment in the clinic under the strict supervision of a doctor:
Diet and nutrition in cholangitis are of great importance. In the acute form of the disease, fasting is recommended. When the exacerbation subsides a little, you can gradually expand your diet, not forgetting that you need to eat often, but in small portions.
Any drinks and dishes should be consumed warm. All dishes must be either boiled or steamed.
You can eat dishes from lean meat, poultry or fish. Soups are best cooked in water or diluted broth. Showing cereals, pasta and dried bread.
Low-fat dairy products, one-egg omelettes, vegetables, berries and fruits, honey are very good. Sweets should be limited, caramel and marmalade are best suited for this.
Drinks should not be concentrated, it is better to drink tea with milk, dilute juices with water.

Strictly eliminate from the diet
Baking and fresh bread;
Fatty meat, canned food;
Smoked products, sausages;
Mushrooms and mushroom soups;
Spicy dishes and seasonings;
Various sauces;
Coffee, cocoa and chocolate should be excluded in any form;
Alcohol and carbonated drinks.

Prevention
The diet must also be observed in order to prevent cholangitis. Violation of the diet provokes stagnation of bile. For the same purposes it is necessary:
Disturbances in the work of the digestive organs, for example, constipation, should not be allowed. With the necessary treatment and compliance with the recommendations of the doctor, the prognosis is favorable.
Inflammation of the bile ducts
Cholangitis is a fairly common inflammatory disease of the bile ducts. It can develop in both men and women at any age, however, most often cholangitis occurs in adults belonging to the age category from 40 to 60 years.
Causes of the disease
The main reasons for the development of cholangitis include impaired patency of the bile ducts and their infection with various bacterial pathogens. It is generally accepted that obstruction of the bile ducts and the attachment of infection to them can occur as a result of:
the formation of stones (stones) in the bile ducts;
strictures (narrowing) of the bile ducts;
the occurrence of a tumor lesion of both the bile ducts themselves and the head of the pancreas or the major papilla of the duodenum 12;
surgical intervention performed on the biliary tract;
the presence of congenital or acquired cysts in the biliary tract;
helminthic invasion;
the presence in the body of various bacterial infections penetrating into the biliary tract from the intestines, gallbladder or through the lymph, blood from an inflammatory focus localized in any other organ, part of the body;
autoimmune disorders.

Medical specialists also note that in some cases the disease in question can develop due to drug, viral, cholestatic and alcoholic hepatitis or against the background of progressive allergic, toxic conditions.
Disease classification
Cholangitis has a fairly extensive classification.
According to its course, cholangitis is divided into two forms: acute and chronic.
Each of these forms also has its own individual classification, due to the characteristic features of both the course of cholangitis itself and the developed morphological changes. According to this classification, the disease is divided into:
catarrhal, diphtheritic, necrotic and purulent cholangitis (with an acute form of the course);
proliferative, fibrosing, stenosing, sclerosing, latent, recurrent, abscessing and septic cholangitis (in the chronic form of the course).

According to the identified etiology, cholangitis is classified into: bacterial (aerobic, anaerobic, mixed), helminthic, toxic, autoimmune, toxic-allergic, viral.

According to its pathogenesis, the disease is divided into: primary (may be primary sclerosing or autoimmune) and secondary (usually bacterial and helminthic).
According to the degree of progression and spread of the existing inflammatory process in the bile ducts, cholangitis is divided into: total, widespread, segmental.
Symptoms of the disease
Symptoms in acute form
Acute cholangitis in most cases is characterized by the manifestation of pronounced symptoms. Medical specialists distinguish such symptoms of this form of the disease as:
fever;
acute pain in the right hypochondrium;
increased sweating;
bouts of nausea, vomiting;
severe skin itching;
yellowing of the skin, whites of the eyes.

Sometimes the symptoms of acute cholangitis are mild and subtle. Usually, such symptoms are observed in elderly people due to the fact that a progressive disease acquires a purulent (phlegmonous) form in them.
Symptoms in the chronic form
Chronic cholangitis usually occurs in latent form without obvious manifestations of the disease. Patients, as a rule, do not feel painful discomfort and can only detect such specific symptoms as:
the constant presence of physical malaise, increased fatigue, general weakness;
periodic increase in body temperature;
persistent skin itching;
intense redness of the palms;
decrease total weight body;
yellowness of the skin;
constant bouts of headache;
anemia.

Doctors also note that in the presence of stones in the gallbladder or in the bile ducts, all of the above symptoms of chronic cholangitis can complement pains of varying intensity with a location in the right hypochondrium.
Diagnosis of the disease
Cholangitis is usually detected using a comprehensive diagnosis, including:
anamnesis;
physical examination;
various hardware and laboratory types of research (ultrasound, fluoroscopy, radioisotope research, cholangiomanometry, bile duct endoscopy, as well as general and biochemical laboratory tests blood, microbiological research bile).

After being placed accurate diagnosis The medical specialist determines the basic treatment for cholangitis.
Treatment of the disease in question can be carried out both conservatively and surgically, depending on the developed form of cholangitis. Treatment of cholangitis is always carried out only in a hospital, since with this disease there is enough high probability rapid development severe complications as purulent abscesses and peritonitis.
In cases where the ongoing conservative treatment does not give any positive results or with the help of medications it is not possible to create an optimal outflow of bile, doctors prescribe a surgical treatment of the disease.
Cholangitis: symptoms and treatment
Cholangitis - the main symptoms:
Weakness
Nausea
Vomit
Chills
Liver enlargement
Bitterness in the mouth
Pain in the right hypochondrium
Fever
Jaundice
lethargy
Yellowing of the eye

The liver is one of the most important organs human body along with the heart, brain, lungs. There are a lot of tasks that the liver performs: this is filtering all kinds of toxins, and the production of glycogen, and the storage of some vitamins (A, D, B12). Refers to the functions of the liver and the synthesis of bile. First, bile is collected in the hepatic bile ducts, and then goes through the common bile duct to the gallbladder. Inflammation of these bile ducts is the main feature of a fairly common disease - cholangitis.
Causes
Two factors contribute to the occurrence and development of cholangitis: stagnation of bile and the presence of infection. This set of circumstances can be caused by the following reasons:
In addition to these causes, inflammation of the bile ducts can be provoked by some viruses - for example, hepatitis C.
Classification of varieties of the disease
In the previous section, various types of cholangitis were considered, which differed in the causes of the disease. So, for example, there are bacterial, viral, autoimmune and helminthic types of the disease. However, cholangitis is also divided according to other features. The main types will be discussed below.
Primary sclerosing type
About what constitutes primary sclerosing cholangitis, it was said a little above, but it would be useful to consider this issue in more detail. It’s worth starting with the fact that this is chronic cholangitis, in which scars form in the bile ducts. As a result, bile cannot move normally through the channels, which means that the liver does not work as it should.
The causes contributing to the development of a disease such as primary sclerosing cholangitis are not fully understood, but it is assumed that this is due to autoimmune diseases. People whose relatives were ill with this disease fall into the risk category. Also, primary sclerosing cholangitis occurs somewhat more often in men than in women.
Purulent type of disease
Purulent cholangitis usually has bacterial nature and is characterized by the presence of wounds on the walls of the bile ducts. Wounds begin to fester over time, in some cases tissue necrosis may even begin. This type of disease sometimes behaves like acute cholangitis, and sometimes takes a chronic form.
The purulent type of cholangitis is dangerous, first of all, because its picture of the disease is similar to other varieties of this disease, and the wrong and untimely treatment can lead to serious complications: liver failure, the occurrence of many abscesses in the liver, purulent intoxication, etc.
Cholecystocholangitis
Manifestations of the disease
Despite the fact that there are several different types of cholangitis (including the already mentioned primary sclerosing cholangitis, cholecystocholangitis, etc.), their symptoms are quite similar. These characteristic signs of cholangitis will be listed below.
Yellowing of the skin and whites of the eyes. Occurs due to stagnation of bile.
Severe fever, chills. Especially such symptoms are characteristic if acute cholangitis occurs.
Pain in the right hypochondrium.
Bitterness in the mouth, nausea, strong vomiting.
Enlargement of the liver in size.
Weakness, lethargy.

In the acute form of the disease, all these symptoms will be very pronounced, so it will be difficult not to notice them. But in the chronic form, all the symptoms are somewhat muffled: instead of fever, subfebrile condition is observed, instead of constant vomiting - slight nausea, pain in the hypochondrium is not so strong. On the one hand, the chronic form of the disease is less painful for the patient, on the other hand, a person often decides to endure not too much pain, and in the case of cholangitis, this can have disastrous consequences.
Diagnostic methods
Symptoms of cholangitis, especially acute cholangitis, are pronounced and indicate problems with the liver, however, in order to make an accurate diagnosis and prescribe treatment for cholangitis, a number of additional tests. Here are the main ones:
Treatment of cholangitis can be done both in the outpatient clinic and in the hospital department. The patient must be freed from physical activity. Treatment methods work in a complex, therefore it is important not to miss any of its sides.
Feeding method
The diet for cholangitis involves the rejection of fatty foods, alcohol, fried foods, dishes with an abundance of spices, smoked meats, and canned food. Don't eat garlic or onions either. You need to eat often and little by little so as not to overload the liver. The following products will also benefit:
Low-fat meats (veal, chicken fillet, rabbit meat) and fish (hake, pike perch).
Low fat dairy products(kefir, fermented baked milk, fat-free cottage cheese).
Kashi, especially buckwheat and oatmeal.
Vegetables - boiled or steamed.

Also important for cholangitis drinking regimen- At least 1.5-2 liters of clean water should be consumed per day.
Medical treatment
During acute attacks, the treatment of cholangitis involves taking drugs that can relieve inflammation. Usually these are broad-spectrum antibiotics, such as tetracycline, biomycin. Sedatives and painkillers are prescribed to relieve pain.
Conservative therapy
When acute inflammation has been removed, to improve the patient's condition, common ways treatment. Good results in this regard are given by staying in resorts. mineral waters, also shows some physiotherapy (diathermy, UHF), special sets of exercises, mud and paraffin applications.
In conclusion, it can be noted that the symptoms of cholangitis are sometimes not too noticeable, but it is important to pay attention to them in time. The treatment of cholangitis at the present time is not too difficult, especially on early stages, but if you start the disease, then the complications can be very serious - up to cirrhosis of the liver.
If you think that you have Cholangitis and the symptoms characteristic of this disease, then doctors can help you: a gastroenterologist, a hepatologist.
We also suggest using our online disease diagnostic service, which, based on the symptoms entered, selects probable diseases.
Liver cancer is a rather severe disease characterized by the development of a malignant tumor in the liver. Liver cancer, the symptoms of which have characteristic features, can occur as a result of exposure to such underlying factors as cirrhosis of the liver, viral hepatitis, and the consumption of products that include aflatoxin.
Jaundice is a pathological process, the formation of which is affected by a high concentration of bilirubin in the blood. The disease can be diagnosed in both adults and children. call like this pathological condition capable of any disease, and they are all completely different.
Gallbladder stones form due to metabolic problems in the body. They are the cause of the occurrence of GSD. Calculi formed in the organ can be located anywhere - both in the bladder itself and in its ducts, and even in the liver, while their shape and size vary from very small (sand) to very large.
Sclerosing cholangitis is a rare liver disease characterized by inflammation and blockage. hepatic ducts both within the body and outside it. Usually, when they talk about this disease, they mean primary sclerosing cholangitis, the causes of which are not fully understood. Such a pathology is determined randomly during surgical operations on the organ. And the disease for a long time may be asymptomatic, therefore, even if inflammation of the ducts and their sclerosis by scar tissue are detected, the symptoms of the disease in a person may not yet appear. At the same time, not receiving timely treatment, people very quickly face a serious condition - liver failure.
Cirrhosis of the liver is chronic illness, due to the progressive replacement of the parenchymal tissue of the liver with fibrous connective tissue, which results in a restructuring of its structure and a violation of actual functions. The main symptoms of cirrhosis of the liver are jaundice, an increase in the size of the liver and spleen, pain in the right hypochondrium.
With the help of exercise and abstinence, most people can do without medicine.
Symptoms and treatment of human diseases
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Questions and suggestions:
Cholangitis
Cholangitis is a nonspecific inflammatory lesion of the bile ducts of an acute or chronic course. With cholangitis, there is pain in the right hypochondrium, fever with chills, dyspeptic disorders, jaundice. Diagnosis of cholangitis includes analysis of biochemical parameters of blood, fractional duodenal sounding with bacteriological examination of bile, ultrasound, percutaneous transhepatic cholangiography, ERCP. In the treatment of cholangitis, antibiotic therapy, detoxification therapy, the appointment of enzymes, FTL (mud therapy, sodium chloride baths, paraffin and ozokerite therapy, UHF, diathermy), and sometimes surgical decompression of the biliary tract are used.
Cholangitis
With cholangitis, intra- or extrahepatic bile ducts may be affected. The disease often occurs in women aged 50-60 years. In gastroenterology, cholangitis is usually diagnosed together with gastroduodenitis, cholecystitis, hepatitis, cholelithiasis, and pancreatitis.
Cholangitis classification
The course of cholangitis can be acute and chronic. Depending on pathomorphological changes, acute cholangitis can take a catarrhal, purulent, diphtheritic or necrotic form. Catarrhal cholangitis is characterized by hyperemia and edema of the mucous membrane of the bile ducts, leukocyte infiltration of their walls, and desquamation of the epithelium. With purulent cholangitis, the walls of the bile ducts melt and multiple abscesses form. Severe course noted in the formation of fibrinous films on the walls of the bile ducts (diphtheritic cholangitis) and the appearance of foci of necrosis (necrotizing cholangitis).
The most common chronic cholangitis, which can develop as an outcome of acute inflammation or acquire from the very beginning lingering course. Allocate latent, recurrent, long-term septic, abscessing and sclerosing forms of chronic cholangitis. With sclerosing cholangitis in the walls of the bile ducts grows connective tissue, which causes strictures of the bile ducts and their even greater deformation.
Causes of cholangitis
Aseptic enzymatic cholangitis can develop as a result of irritation of the walls of the bile ducts by activated pancreatic juice, which occurs with pancreatobiliary reflux. In this case, aseptic inflammation occurs first, and the attachment of the infection occurs a second time, in a later period.
Sclerosing cholangitis, caused by autoimmune inflammation of the bile ducts, also proceeds according to the aseptic type. At the same time, along with sclerosing cholangitis, nonspecific ulcerative colitis, Crohn's disease, vasculitis, rheumatoid arthritis, thyroiditis, etc.
The prerequisites for the development of cholangitis are cholestasis, which occurs with biliary dyskinesia, bile duct anomalies, choledochal cyst, biliary tract cancer, choledocholithiasis, stenosis of the Vater papilla, etc. The onset of cholangitis may be preceded by iatrogenic damage to the walls of the ducts during endoscopic manipulations (retrograde pancreatocholangiography, installation stents, sphincterotomy) surgical interventions on the bile ducts.
Symptoms of cholangitis
The clinic of acute cholangitis develops suddenly and is characterized by the Charcot triad: high body temperature, pain in the right hypochondrium and jaundice.
Acute cholangitis manifests with fever: a sharp rise in body temperature to 38-40 ° C, chills, severe sweating. At the same time, intense pains appear in the right hypochondrium, resembling biliary colic, with irradiation to the right shoulder and shoulder blade, neck. At acute cholangitis intoxication is rapidly growing, weakness is progressing, appetite is deteriorating, headache, nausea with vomiting, and diarrhea are disturbing. A little later, with acute cholangitis, jaundice appears - a visible yellowing of the skin and sclera. Against the background of jaundice, itching develops, usually aggravated at night and disturbing normal sleep. As a result of severe itching on the body of a patient with cholangitis, scratching of the skin is determined.
In severe cases, disturbances of consciousness and shock phenomena can join Charcot's triad - in this case, a symptom complex called Reynolds' pentad develops.
Clinical manifestations of chronic cholangitis are blurred, but progressive. The disease is characterized by dull pains in the right side of low intensity, a feeling of discomfort and fullness in the epigastrium. Jaundice in chronic cholangitis develops late and indicates far-reaching changes. Common disorders in chronic cholangitis include subfebrile condition, fatigue, weakness.
Complications of cholangitis can be cholecystopancreatitis, hepatitis, biliary cirrhosis, multiple liver abscesses, peritonitis, sepsis, toxic shock, liver failure.
Diagnosis of cholangitis
It is usually possible to suspect cholangitis on the basis of Charcot's characteristic triad; clarifying diagnosis is carried out on the basis of laboratory and instrumental studies.
Imaging methods for diagnosing cholangitis include ultrasound of the abdominal cavity and liver, ultrasonography of the biliary tract, and CT. With their help, it is possible to obtain an image of the bile ducts, identify their expansion, determine the presence of structural and focal changes in the liver.
Among the instrumental methods for diagnosing cholangitis, the leading role is played by endoscopic retrograde cholangiography, magnetic resonance cholangiography (MRCP), and percutaneous transhepatic cholangiography. On the obtained radiographs and tomograms, the structure of the biliary tract is well visualized, which makes it possible to identify the cause of their obstruction.
Differential diagnosis of cholangitis is necessary with cholelithiasis, non-calculous cholecystitis, viral hepatitis, primary biliary cirrhosis, pleural empyema, right-sided pneumonia.
Treatment of cholangitis
Since the treatment of cholangitis is impossible without the normalization of the function of biliary excretion, quite often it is necessary to resort to various kinds surgical interventions. In order to decompress the bile ducts, endoscopic papillosphincterotomy, extraction of bile duct calculi, endoscopic stenting of the common bile duct, percutaneous transhepatic drainage of the bile ducts, external drainage of the bile ducts, and other interventions can be performed. The most effective treatment for sclerosing cholangitis is liver transplantation.
Forecast and prevention of cholangitis
With cholangitis complicated by abscess formation, cirrhosis, hepatic-renal failure, generalized septic process, the prognosis is unsatisfactory. Timely therapy of catarrhal cholangitis allows to achieve a cure; with purulent, diphtheritic and necrotic form- the prognosis is more serious. The long course of chronic cholangitis can lead to permanent disability.
Prevention of cholangitis dictates the need for timely treatment of gastroduodenitis, acalculous cholecystitis, gallstone disease, pancreatitis, helminthic and protozoal invasions; observations at the gastroenterologist after undergoing surgical interventions on the biliary tract.