Achylia Pancreatica

ACHYLIA PANCREATICA, such a state of the duodenum in which there is a delay in the secretion of pancreatic excretions due to causes of mechanical or inflammatory character. A. p. arises in the following way: either from compression by a stone, a tumor, a scar of the pancreatic duct, as a result of which the pancreatic secretion does not get into the duodenum, or as a result of an independent process in the pancreatic gland itself. These processes may be accompanied by anatomical changes and lead to atrophy of the organ (pancreatitis), but they may also be functional, i.e., without visible anatomical changes. The question of A. p. is little developed due to the absence of a method that allows one to obtain pancreatic juice in a pure form. One has to judge about this anomaly by the character of the feces; in it, primarily, digestion of meat is disturbed (creatorrea), although incomplete splitting of fat (steatorrea) is also observed. The pancreas has a close connection with the stomach, since its secretion is regulated by reflexes originating from the duodenum during the passage of gastric contents through it. Therefore, it was thought that gastric achylia could reduce the secretion of the pancreas. However, new works by Meiner (Meunepg), who obtained pancreatic juice using a thin probe, showed that only in exceptional cases is there also a cessation of pancreatic secretion during gastric achylia. Symptoms of A. p. are persistent diarrhea with the disappearance of pancreatic enzymes in the feces, with creatorrea and steatorrea. A more accurate diagnosis of A. p. can be made on the basis of a thorough study of the feces on a test diet (A. Schmidt) with a study of the degree of digestion of food substances. These data are supplemented by the study of the content of enzymes of pancreatic juice obtained with the help of a thin probe.