Babkina E

Babkina E.P. ,Shevchenko J.A., Hamachek I.G., Korobko I.S.

SZ "Lugansk State Medical University"(Lugansk)

LIMITATION OF CAUSING MECHANICAL INJURIES FOR DYNAMIC CHANGES HISTOLOGICAL PARAMETERS PANCREAS

Introduction. The data presented in the literature concerning the characteristics of damage parts of the pancreas differ. Some authors suggest that isolated damage to the body of the pancreas observed in 52% and 16.4% in the head, tail, and in 10% of all cancer in 17.6%, often trauma of the pancreas was observed together with the trauma of other abdominal organs (liver , spleen, kidney, stomach, etc.) [1-8]. The aim of this work was to study the dynamic changes of histological parameters injured pancreas tissues in various types of mechanical injury, depending on the period of injury. Material and methods. The material for the present study, there are tissues of the pancreas 165 people male and female, aged 20 to 60 years, who died at a known and an unknown time of injury and death in the presence and absence of alcohol in the blood and subjected to autopsy in tanatological Department Office of Forensic medical examination of Lugansk during 2005-2011 years. In research conducted used: histological, histochemical techniques to detect dynamic processes of regeneration histological parameters injured tissues of the pancreas and performed statistical analysis of the results. Results and discussion. According to our data in the thoraco-abdominal trauma with damage to the pancreas, histological examination to 6 hours after the infliction of trauma, damage zone are erythrocytes with clear contours, vessels in the accumulation of leukocytes at sites of hemorrhage leukocytes are diffusely. Revealed edema of the stroma. They begin to appear signs of fat necrosis. After 6-12 hours after the onset of hemorrhage injury in the form of clusters of red blood cells with clear contours, but red blood cells in the center of hemorrhage unclear, a growing number of white blood cells in blood vessels and tissues that concentrate perifocal. Stored stromal edema, there is sero-hemorrhagic and hemorragic swelling. Increases the number of fat necrosis. In some cases, hemorrhage determined in adipose tissue, which is located around the pancreas. Within 12 to 24 hours erythrocytes represented as granular masses, in place of injured areas appear necrotic tissue. In areas of perifocal inflammation among leukocytes are macrophages, lymphoid cells containing granular pigment (hemosiderin). Distributed swelling. It should also be noted that in this period the inflammatory infiltration increases and the number of fat necrosis, in contrast, decreases. At the 2-3rd day well distinguished demarcation line around parenchymal necrosis and surrounding fat. In this period also distinct leukocyte infiltration, there is a significant amount of fat necrosis, edema spreads. In infiltrates appear lymphocytes, macrophages isolated histiocytes. In some areas there is infiltration in the form of widespread purulent inflammation. After 4-6 days after causing injury continues to increase the number of fat necrosis in the zone infiltrates increased number of lymphocytes, macrophages, histiocytes. Currently, the term begins to form demarcation line. After the sixth day in the damage zone pancreas begins rejection of necrotic tissue with cellular transformation perifocal infiltration of histiocytic lymphoma. Turns proliferation of fibroblasts from the walls of blood vessels, which continues for 1-2-weeks. From the third week there was a consistent proliferation of fibroblasts, forming delicate connective tissue fibers appear young vessels. Conclusions. The research results show that our data are consistent with literary sources, which states that traumatic injuries of the pancreas characterized by a high mortality rate that can reach according to the literature from 15 to 40%, according to our - 28%. The study has established regular changes of histological parameters pancreatic tissue depending on the period of causing injury to the time of death, the presence of traumatic illness, etc., to help in solving important for law enforcement agencies on the definition of limitation, the sequence of injury in injured and people died during mechanical trauma.

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