Avramenko A. A. A CASE OF FORMATION OF "KISSING" ULCERS OF THE DUODENAL BULB AND REACTIVE PANCREATITIS IN A SEAFARER = СЛУЧАЙ ФОРМИРОВАНИЯ «ЦЕЛУЮЩИХСЯ» ЯЗВ ЛУКОВИЦЫ ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ И РЕАКТИВНОГО ПАНКРЕАТИТА У МОРЯКА. ВІСНИК МОРСЬКОЇ МЕДИЦИНИ. 2020;4(89):18-22. ISSN 0049-6804. DOI http://dx.doi.org/10.5281/zenodo.4430738 http://www.herald.com.ua УДК 616.342-002.44:616.37-002 DOI http://dx.doi.org/10.5281/zenodo.4430738 A CASE OF FORMATION OF "KISSING" ULCERS OF THE DUODENAL BULB AND REACTIVE PANCREATITIS IN A SEAFARER A. A. Avramenko International Classical University named after Pylyp Orlik, Nikolaev; e-mail: aaahelic@gmail.com СЛУЧАЙ ФОРМИРОВАНИЯ «ЦЕЛУЮЩИХСЯ» ЯЗВ ЛУКОВИЦЫ ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ И РЕАКТИВНОГО ПАНКРЕАТИТА У МОРЯКА А. А. Авраменко Международный классический университет имени Пилипа Орлика, г. Николаев, Украина Summary The relationship between the ship's crew members is the basis for normal working conditions for the crew, given the limited space on the ship, while conflict situations can serve as a trigger for the development of diseases such as peptic ulcer and pancreatitis. Purpose of the study: to analyze the case of the formation of "kissing" ulcers of the duodenal bulb and reactive pancreatitis in a 24-year-old sailor during a 10-month voyage. Contingent and methods. The examination of the patient was carried out at the Center for Progressive Medicine "Rea +Med" (Nikolaev). Examination methods: clinical and anamnestic, instrumental, histological, bacteriological. Results. During the survey, it was found that 2 months before the onset of epigastric pain, the patient was in a tense relationship with the ship's management for 5.5 months; 0.5 months before the onset of pain, he participated in unloading and loading operations (multiple transfer of goods up to 50 kg at a distance of 100 meters). The acidity level during the pH-metry corresponded to the absolute normality, during the EGDS, “kissing” ulcers of the duodenal bulb were detected, the data of histological studies and samples for Helicobacter pylori infection confirmed the presence of chronic non-atrophic gastritis in the patient in an active form, and ultrasound examination of the abdominal organs revealed the presence of reactive pancreatitis. Conclusion. A long-term conflict situation served as a trigger, which, according to the theory of "caustic alkaline spitting", later formed a mechanism that led to the formation of "kissing" ulcers of the duodenal bulb, and after 2 weeks - reactive pancreatitis. Key words: conflict situation; chronic non-atrophic gastritis; "kissing" ulcers of the duodenal bulb; reactive pancreatitis.