Chapter 5 The Pancreas Flashcards by LILY ALCARAZ

The sonographic assessment of a pancreatic transplant includes:

•evaluation of vascularity
•pancreatic parenchyma
•search for fluid collections

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With ______, the donors duodenum is anastomosed to a loop of the jejunum

Exocrine enteric drainage

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With ______, the vasculature of the donor pancreas is anastomosed to the recipients common iliac vessels and the donors duodenum is anastomosed to the bladder

Exocrine bladder drainage

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The anteroposterior diameter of the main pancreatic duct should not exceed ______

2mm

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______position May help improve visualization of the pancreatic head

LLD

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Sonographic findings of chronic pancreatitis

•heterogenous or hyperechoic atrophic gland
•calcifications
•pancreatic pseudocyst
•dilated pancreatic duct
•stones within the pancreatic duct
•portosplenic vein thrombosis

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Clinical findings of chronic pancreatitis

Asymptomatic
Epigastric pain
Jaundice
Back pain
Elevation in amylase or lipase
Elevation in ALP
Anorexia
Vomiting
Weight loss
Constipation

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____is the removal of the head of the pancreas, the gallbladder, some of the bile ducts and the proximal duodenum

Whipple procedure

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The surgical procedure that is performed on patients with pancreatic adenocarcinoma is called

Whipple procedure

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The most common location of pancreatic adenocarcinoma is

pancreatic head

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____is the most primary pancreatic malignancy and it is most commonly discovered in men

Pancreatic adenocarcinoma

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Mucinous tumor are

•large
•malignant potential

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Serous tumors are

•small
•always benign

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Mucinous cystadenocarcinoma are found

body and tail of the pancreas

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Unencapsulated anechoic fluid collection surrounding all our part of the pancreas is called

Peripancreatic fluid

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The body and tail of the pancreas receive their blood supply from the

Splenic artery and SMA

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The arterial blood supply to the head of the pancreas is via

Gastroduodenal artery

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The two most common congenital anomalies of the pancreas are

• Pancreatic divisum
• Annular pancreas

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The pancreatic tail should measure between

1-2cm

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The normal measurement of the pancreatic head and body is between

2-3cm

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______results from abnormal fusion of the pancreatic duct during embryologic development

Pancreatic divisum

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With _______, the most ventral part of the pancreas encases the duodenum and May consequently lead to duodenal obstruction

Annular pancreas

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The most common cause of acute pancreatitis are

•alcohol abuse
•biliary tract disease

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With diffuse enlargement of the pancreas it will become:

Enlarged and hypoechoic

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______will lead to an enlargement of the gland in a particular segment, most often in the head, appearing as a hypoechoic region

Focal pancreatitis

The opening of the sphincter of oddi is triggered by ______released by the duodenum as a result of the presence of chyme

Cholecystokinin

Endocrine tumors Can be found within the

Islets of langerhans

Insulin stimulates the body to use up:

glucagon to produce energy

____is the hormone released by the pancreas that encourages the body’s use of glucagon

Insulin

Which part of the pancreas is located anterior to portal confluence

Pancreatic neck

What vascular structure outlines the pancreatic tail posteriorly

Splenic vein

Which part of the pancreas is located right lateral to superior mesenteric vein, anterior to IVC and inferior to portal vein

Head

The pancreas is a:

Retroperitoneal organ

Courvoisier gallbladder is the

Enlarged GB caused by pancreatic head mass

**Coexisting obstruction** of the **common bile duct** and **pancreatic duct** may be referred to as

Double duct sign

Within which parts of the _pancreas_ are **mucinous cystadenocarcinomas** most often **located**

Body and tail

What is the early sonographic appearance of acute pancreatitis

Normal

The arterial blood supply to the head of the pancreas is via the

Gastroduodenal artery

The most common echogencity of a acutely inflamed pancreas is

Hypoechoic

Which cells perform the exocrine function of the pancreas

Acinar cells

The portion of the bowel that encompasses the head of the pancreas is the

Duodenum

What is the name of the main pancreatic duct

Duct of wirsung

The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the

Sphincter of oddi

A gastrinoma of the pancreas can produce

Zollinger-Ellison syndrome

Courvoisier gallbladder is found in the presence of

Adenocarcinoma in the head of the pancreas

______is the most common islet cell tumor

Insulinoma

One of the most common locations for a pancreatic pseudocyst is within the

Lesser sac

Which type of pancreatic transplantation is more common

Exocrine enteric drainage

Clinical findings of acute pancreatitis

1. Elevated labs 2. Leukocytosis 3. Pain 4. Fever 5. Nausea

The most common location of focal pancreatitis is within the

Head of the pancreas

_____is a peripancreatic fluid collection that results from the inflammation of the pancreas

Phlegmon

The most common location of adenocarcinoma of the pancreas is within the

Head of the pancreas

_____is the enzyme released by the pancreas that neutralizes stomach acid

Sodium bicarbonate

The whipple procedure is performed on patients who have

Pancreatic carcinoma

The most common form of malignant of the pancreas is

Adenocarcinoma

What is another name for the accessory duct of the pancreas

Duct of santorini

What results in a shortened main pancreatic duct that works to drain only the pancreatic head and not the entire pancreas

Pancreatic divisum

______is located within the epigastrium between the C-loop of the duodenum and the splenic hilum

Pancreas

The pancreas consists of four main parts

•head •neck •body •tail

The pancreas is considered to be a _______organ

Retroperitoneal

In some individuals, there exists a posteromedial extension of the pancreas head, referred to as

Uncinate process

The endocrine function of the pancreas is performed by the

Islets of langerhans

The ______of the pancreas carry out the exocrine function because they produce viral digestive enzymes (amylase, lipase, sodium bicarbonate)

Acinar cells

Primarily, the pancreas is an exocrine gland that aids in _____

Digestion

Sonographic findings of chronic pancreatic transplant rejection

1. Hyperechoic echotexture 2. Atrophy 3. Pancreas may contain calcifications

Sonographic findings of acute pancreatic transplant rejection

1. Hypoechoic or heterogenous gland 2. Elevated resistive indices

Sonographic findings of true pancreatic cysts

1. Well-defined, anechoic mass with posterior enhancement

Clinical findings of true pancreatic cysts

•possible history of von hippel-lindau disease or cystic fibrosis •possible history of ADPKD

Sonographic findings of islet cell tumors

•hypoechoic mass that may contain calcifications

Clinical findings of islet cell tumors

•insulinoma: low blood sugar symptoms •gastrinoma: Zollinger-Ellison syndrome

Clinical findings of acute pancreatitis

•elevated amylase (within 24hrs) •elevated lipase (within 72 hrs) •elevated ALT and other labs with biliary obstruction •leukocytosis •abdominal pain (supine) •back pain •fever •nausea and vomiting •hemorrhage and low hematocrit

Sonographic findings of acute pancreatitis

•normal pancreas •diffused pancreas •focal pancreas •peripancreatic pseudocyst •abscess formation (fluid gas bubbles) •biliary obstruction •splenic vein thrombosis and psedoaneurysm of the splenic artery

Sonographic findings of serous cystadenoma (2):

1. Cystic mass 2. Solid and echogenic secondary to the small size of the cysts

Sonographic findings of mucinous cystadenoma and cystadenocarcinoma

1. Multilocular cystic masses that may contain mural nodules and calcifications 2. Dilation of the pancreatic duct

There are two common types of transplantation techniques

•exocrine bladder drainage •exocrine enteric drainage

______is described as the excessive section of acid by the stomach that leads to peptic ulcers

Zollinger-Ellison syndrome

_____is a branch of the main pancreatic duct, had a separate minor sphincter into the duodenum

Duct of santorini

At the ______the pancreatic digestive enzymes are mixed with bile from the liver and released into the duodenum through the______

•ampulla of vater •sphincter of oddi

Clinical findings of pancreatic adenocarcinoma (7):

1. Elevated amylase and lipase 2. No appetite 3. Weight loss 4. Jaundice 5. Courvoiser gallbladder 6. Epigastric pain 7. Elevated ALP and other liver function labs associated with biliary obstruction

Sonographic findings of pancreatic adenocarcinoma

1. hypoechoic mass 2. head of the pancreas 3. dilated CBD and pancreatic duct (double duct sign) 4. Elevated labs 5. enlarged gallbladder (hydropic)

Clinical findings of cystadenoma and cystadenocarcinoma

•May be asymptomatic initially • epigastric pain •weight loss •palpable mass •jaundice

Chapter 5 The Pancreas Flashcards

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