11.1 - Exocrine Pancreas Flashcards
annular pancreas
- developmental malformation
- pancreas forms ring around the duodeum = obstruction
Acute pancreatitis
- inflammation and hemorrhage of pancreas
- Premature activation of trypsin = activation of other enzymes = autodigestion by pancreatic enzymes
What kind of damage in acute pancreatitis?
autodigestion =
- liquefactant necrosis with hemorrhage
- fat necrosis (saponification - digestion of fat by pancreatic enzymes)
2 most common causes of acute pancreatitis?
alcohol and gallstones
Classic presentation of acute pancreatitis?
- epigastric abdominal pain radiating to the back
- nausea and vomit
- periumbilical and flank hemorrhage
- INC serum lipase (MORE SPECIFIC THAN AMYLASE BC AMYLASE FROM SALIVARY GLANDS TOO)
- INC amylase
- hypocalcemia (poor prognosis)
What is chronic pancreatitis?
Many bouts of acute pancreatitis = fibrosis of pancreatic parenchyma
Main cause for chronic pancreatitis-
Adults?
Children?
- Alcohol
- cystic fibrosis
Clinical features of chronic pancreatitis?
- epigastric abdominal pain radiating to back
- -pancreatic insufficiency = malabsorption and steatorrhea
- dystrophic calcification of pancreas
- secondary diabetes mellitus(late)
- inc risk for pancreatic carcinoma
Pancreatic carcinoma
- what kind of tumor/from what cells?
- population that is mainly affected?
- major risk factors?
- adenocarcinoma from pancreatic ducts
- elderly
- -major risk factors = smoking and chronic pancreatitis
Pancreatic carcinoma
-presentation?
- epigastric abdominal pain
- WL
- obstructive jaundice, pale stools, & palpable gallbladder (=head of pancreas tumor)
- secondary diabetes mellitus (=body or tail of pancreas)
Thin diabetic elderly lady presents to clinic - what should be on your mind?
pancreatic carcinoma - not the right population for diabetes and WL?
Serum pancreatic carcinoma marker =
CA 19-9
Tx of pancreatic CA?
Whipple procedure: head and neck of pancreas, duodenum, and gallbladder – Poor prognosis/survival
