Definition

“ Dushta rakta atimatratvat sa vai seeghram vidahyate tatah seeghra vidahitvat vidradhi ityabhidheeyate l “ ( Ca. su 17/ 95)

Due to an excessive vitiation of rakta, abscess gets suppurated quickly. This is called vidradhi because of vidaha.

Bahya and abhyantara.

Abhyantara vidradhi is further divided into 4 different types:

Vatiki, paittiki slaishmiki and sannipatiki.

o Excessive intake of food which is seetaka,vidahi, ushna,

ruksha, viruddha, ajirna, samklishta,vishama and asatmya.

o Intake of vyapanna madya.o Excessive intake of madya.o Vegasandharana, srama, jihma vyayama, shayana,

atibhara,atyadhwa, atimaidhuna

Antahshareere mamsaasruk aavishanti yadaa malaa ….

Malas reaching the mamsa and asrk of antahshareera giving rise to granthi which is fatal.

SITES• Hrudaya• Kloma• Yakrut• Pleeha• Kukshi• Vrkka• Nabhi• Vankshana• Vasti

Vidradhi of kloma results in pipasa, mukhasosha and galagraha.

Vidradhi of kukshi causes sula in kukshi,parsva and amsa.

o Sannipathiki maranaaya.o Chirothitha vidradhi is like sastra, sarpa, vidyut

and agni.o So it should be treated very quickly.

1. Gallstones (30-60 %)

2. Alcohol (15-30 %)

3. Hypertriglyceridemia ( 1.3-3.8 %)• Serum triglyceride> 11.3 mmol/L• Derangement in lipid metabolism unrelated to

pancreas.• Diabetes mellitus / who are on certain medications also

develop high triglyceride levels.

4. ERCP ( Endoscopic Retrograde Cholangio Pancreatography ) 5-20 %

5. Drug related 2-5 % Either by hypersensitivity rection or by generation

of a toxic metabolite.6. Sphincter of Oddi dysfunction7. Trauma especially blunt abdominal trauma

UNCOMMON CAUSES

1. Vascular causes and vasculitis.2. Connectivse tissue disorders and thrombotic

thrombocytopenic purpura( TTP )

1. Cancer of pancreas.2. Hypercalcemia.3. Periampullary diverticulum.4. Pancreas divisum.5. Hereditary pancreatitis.6. Cystic fibrosis7. Renal failure

RARE CAUSES10. Infection ( Mumps, coxsackie virus, cytomegalovirus,

parasites)11. Autoimmune ( eg: Sjögren’s Syndrome )

PANCREATITIS

Causes: Infection Improperly treated Obstruction acute pancreatitis Incompletely treated acute pancreatitis

ACUTE CHRONIC

Inflammation of pancreas

hypersecretion of pancreatic juice

Autodigestion of pancretic tissue

Collection of serous material in the pancretic duct and peritoneal covering

Septicemia leading to hypovolemic shock

Acute circulatory failure Coma andDEATH

Obstruction below the level of pancreatic duct

Stasis of pancretic juice

Autodigestion of the pancreas

Collection of serous fluid in the peritoneal sac

Hypovolemia

Shock, coma and Death

o Abdominal paino Burning and pricking type of pain in the

epigastric regiono Fever in case of infectiono Obstructive jaundice, itching, clay coloured

stools in case of obstructiono Nausea, vomitting, abdominal distensiono Increased pulse,decreased BP,Tachypnoeao Cullen’s sign,Turner’s sign

Haemoglobin TC ,DC[increases in infection] ESR [increases in infection] LFT[increases in obstruction] Serum amylase ( Normal- within 200 units/dl ) USG,CT,MRI,ERCP[in case of chronic

pseudopanceatic cyst can be seen] In chronic Fbs,Rbs,PPbs increases

Chronic abdominal pain Decreased appetite Low protein digestion Jaundice

HARRISON’S PRINCIPLES OF INTERNAL MEDICINE CHARAKA SAMHITA CURRENT SURGERY – Dr. J.C.PAL CONCISE MEDICAL PHYSIOLOGY- CHAUDHARI INTERACTIVE WORKSHOP ON AYURVEDA

(HEPATOLOGICAL DISORDERS) 30 - 31 JAN. 2007,NEW DELHI ESSENTIALS OF MEDICAL PHYSIOLOGY - JAYPEE

Dr.SIVA RAMA PRASAD.K Dr. KRISHNA KUMAR