Chapter 12- Pancreas Flashcards
(56 cards)
Extrapancreatic fluid collections are often seen in cases of severe acute pancreatitis. Where are they most commonly located and when do they occur?
lesser sac or around the kidney. They typically occur 4 weeks after infection.
Does the pancreas have a true capsule
No
What happens at 6 weeks embryonic age to create the final pancreas
The ventral bud rotates 270 degrees to fuse with the dorsal bud.
Where is agenesis of the pancreas typically located?
Agenesis of the body and tail. Sometimes with hypertrophy of head.
Explain pancreas divisum. What is it associated with?
Lack of fusion between dorsal and ventral buds. Dorsal drains through minor and ventral through major papilla. Increased association with pancreatitis.
What is the most common anomaly of the pancreas?
Ectopic pancreatic tissue- found in various locations in the GI tract.
What is an annular pancreas? Who is most at risk?
The head of the pancreas surrounds the duodenum. It is rare but there is a male prevalence.
50 percent of the population has a complete regression of what pancreatic duct?
The accessory duct of Santorini
The pancreas has two functions. What do they do and what percent of the function are they?
Endocrine function is 1-2% and secretes hormones to regulate metabolism. Exocrine function is 90% and secretes enzymes to digest food.
What is it called when pancreatic enzymes digest their own tissues? When might this occur
autodigestion might occur with pancreatitits
What are the classifications of acute pancreatitis?
Mild: No organ failure, Moderate: Some systemic complications without failure, Severe: persistent organ failure
What are the symptoms of acute pancreatitis
severe pain radiating to back, elevated amylase, lipase, WBC, sometimes bilirubin.
In cases of pancreatitis, which enzyme is elevated for a longer period of time? Which elevates faster.
Lipase stays elevated longer and elevates earlier.
What is a pancreatic pseudocyst? Who is at risk and when?
A pseudocyst is an acquired collection of amylase developing in 10-20% of patients with acute pancreatitis. It develops 4-6 weeks after the onset.
Where are pseudocysts most commonly found?
most common location is the lesser sac. Second most common is the anterior pararenal space.
What are the clinical symptoms of a pseudocyst? What percent rupture? Is rupture fatal?
asymptomatic, abdominal pain, palpable mass, elevated amylase, lipase, and possibly alk phos if obstruction occurs. 5% rupture with a 50% mortality rate.
Areas of necrosis can lead to rupture of pancreatic vessels and hemorrhage. What are symptoms of this?
Severe ab pain, elevated amylase and lipase, drop in hematocrit. Grey Turner’s sigh- discoloration of flanks
Phlegmonous Pancreatitis is a severe complication of acute pancreatitis. What is it? What percent of patients have extension outside of the pancreas?
Extension of inflammation into other tissues. Most commonly the lesser sac, left ant pararenal space, transverse colon. extension occurs in 18-20% of patients.
When would a pancreatic abscess occur?
As a result of infection of a necrotic pancreas, 2-4 weeks after acute pancreatitis.
Are pancreatic cysts congential or acquired?
Both.
What is autosomal dominant polycystic disease
Multiple cysts found in the liver and kidney that (rarely) extends into the pancreas or spleen
What is cystic fibrosis
A hereditary exocrine disorder resulting in thick mucous secretions that plugs ducts and causes pancreatic dysfunction.
What are symptoms and the appearance of cystic fibrosis
salty sweat, wheezing, fatty stool, increase in echogenicity, gb sludge, calcifications or cysts
What is Von-Hippel-Lindau Syndrome and what is it associated with?
An inherited disorder with formation of tumors and cysts throughout the body. It is associated with hemangioblastomas.