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Question 1

The Atlanta classification of acute pancreatitis:

Answer 1

1- Interstitial oedematous pancreatitis (IEP)

2- Necrotizing pancreatitis:

• pancreatic necrosis
• peripancreatitic hecrosis
• combined type: more common

Early < 1 week
Late > 1 week

Question 2

Types of fluid collection associated with acute pancreatitis?

Answer 2

New terminology for fluid collections associated with acute pancreatitis is introduced:

1- Fluid collections associated with interstitial edematous pancreatitis (i.e. minimal or no necrosis):
A- Acute peripancreatic fluid collections (APFC): in the first 4 weeks: non-encapsulated peripancreatic fluid collections.
B- Pseudocysts: develop after 4 weeks; encapsulated peripancreatic or remote fluid collections.

2- Fluid collections associated with necrotizing pancreatitis:
A- Acute necrotic collections (ANCs): in the first 4 weeks; non-encapsulated heterogeneous non-liquefied material.
B- Walled-off (pancreatic) necrosis (WON or WOPN): develop after 4 weeks; encapsulated heterogeneous non-liquefied material.

Question 3

Adrenal gland arterial supply:

Location:

Venous drainage:

Size:

CT measurements:

Answer 3

Triple arterial supply:
1- superior adrenal artery from inferior phrenic artery
2- middle adrenal artery from aorta
3- inferior adrenal artery from renal artery

Located within the renal fascia but outside the capsule.

Venous drainage through adrenal (suprarenal vein) that drain into:
IVC directly in the right side
Renal vein in the left side

Size:
1/3 the size of the kidney in infant
1/13 the size of kidney in adult

CT measurements:
Length < 4 cm
Limb thickness < 1 cm

Question 4

Persistence of ventral pancreatic bud lead to:

Failure of fusion of pancreatic ducts:

Answer 4

Annular pancreas (as ventral bud remained anterior and failed to go posterior to deudenum)

Failure of fusion lead to pancreatic divisim which is risk factor for chronic pancreatitis

Question 5

Retrocecal space

Answer 5

Normally NOT more than 1.5 cm جالسة على وحدة ونص