CHRNC PNCRTTS Flashcards
(24 cards)
Most common symptom of Chronic pancreatitis
Abdominal pain
Mechanism of abdominal pain in chronic pancreatitis (3)
DIN
Ductal hypertension
Inflammation of Parenchyma
Neural Involvement
Strategies to relieve abdominal pain in Chronic Pancreatitis
Reduce secretion and/or decompress the secretory compartment
Resecting focus of chronic inflammatory change
Neural ablative procedures
True about malabsorption and weight loss in pancreatitis
a. occur when exoctine capacity <10%
b. Associated with Diarrhea and Steatorrhea
c. Stool is described as oil slick
d. if severe steatorrhea, green oily stool is often reported.
e. lipase deficiency tends to manifest itself before trypsin deficiency
D
A chronic collection of pancreatic fluid surrounded by a nonepithelialized wall of granulation tissue and fibrosis
pseudocyst
What percentage of patients with acute pancreatitis develop a pseudocyst?
10%
Acute pseudocyst
a. <7 weeks
b. <6 weeks
c. <5 weeks
d. <4 weeks
B
Acute pseudocyst resolve spontaneously in up to 50% of cases over a course of __ weeks or longer
6 weeks
cut off of pseudocyst size that will resolve less frequently, more likely to be symptomatic
> 6cm
what do you call bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater
Hemosuccus pancreaticus
Symptoms of pseudocysts
PEF
pain
fullness
early satiety
Imaging of choice for pseudocyst
Contrast Enhanced Imaging of choice
A collection of enzyme-rich pancreatic juice that occurs early in the course of acute pancreatitis, or that forms after a pancreatic duct leak; located in or near the pancreas; it lacks a well-organized wall of granulation or fibrous tissue
Peripancreatic fluid collection
A focal or diffuse area of nonviable
pancreatic parenchyma, typically
occupying >30% of the gland and
containing liquefied debris and fluid
Early pancreatic
(sterile) necrosis
An organized collection of sterile
necrotic debris and fluid with a welldefined
margin or wall within the
normal domain of the pancreas
Late pancreatic
(sterile) necrosis
A collection of pancreatic juice enclosed
within a perimeter of early granulation
tissue, usually as a consequence of acute
pancreatitis that has occurred within the
preceding 3–4 wk
Acute pseudocyst
Chronic pseudocyst
A collection of pancreatic fluid
surrounded by a wall of normal
granulation and fibrous tissue, usually
persisting for >6 wk
treatment of pseudocyst if lying posterior to stomach
cystogastrotomy
tx of pseudocyst Ideal for internal drainage
If located at body and tail
Not adhere to stomach , Bulging through T.colon
Cystojejunostomy
tx of pseudocyst if located at head of pancreas
Cystoduodenostomy
most common site of pancreaticoenteric fistula
Transverse colon, splenic flexure
Management of pancreatico fistula to stomach/duodenum
no management, will resolve spontaneously, leave fistula
Low output fistula
a. <300 mL/day
b. <400 mL/day
c. <500 mL/day
d. < 1L/day
e. NOTA
E. <200 mL/day
High output fistula
a. > 200 mL/day
b. > 300 mL/day
c. > 400 mL/day
d. > 500 mL/day
A
