Posts Tagged ‘PB’

Diagnostic Multifocal Puncture Biopsy

Tuesday, June 2nd, 2009

Diagnostic multifocal puncture biopsy (PB) is the next stage of AP diagnosis. The purpose of PB is to verify microbiological and morphological nature of diffuse changes. It is carried out according to diagnostic paracentetic regimens: different needles are applied subsequently while frequency of PB is changed.

According to statistical processing of microbiological and cytologic conclusions, in case of the edematic interstitial form of acute pancreatitis a moderate number of inflammatory elements and a large number of blood elements are often revealed. A large number of blood and inflammatory elements and a moderate quantity of necrotic massess is typical of the necrotic form of AP. The infiltrative necrotic form of AP is characterized by a large number of necrotic masses and inflammatory elements. A large number of necrotic massess and inflammatory elements is also typical of the purulo-necrotic form of AP. The aspirate taken from the abscess cavity usually contains modified blood elements, necrotic masses and inflammatory elements. Exacerbation of the chronic recurrent form of pancreatitis is characterized by inflammatory elements and low-prismatic epithelium with a low degree of proliferation. The cytologic picture of pseudocysts of the pancreas contains inflammatory and blood elements and elements of the cystous cavity.

The majority of patients usually have a negative bacterial inoculation. Microbiological investigation often brings positive results. In most cases bacterial flora constitutes conditional pathogenic enterobacteria of the gram-negative spectrum. Frequency of infection caused by gram-positive agents attained is low (about 25 %).