Lesson 3A (Part 2) Flashcards Preview

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Flashcards in Lesson 3A (Part 2) Deck (30)
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1

What does it mean if the body of the pancreas exceeds 3cm AP?

Acute pancreatitis

2

How much should the pancreatic duct AP measurement be?

3mm or less

3

What is the most common variant of the pancreas?

Pancreatic divisum
- failure of fusion

4

What are 3 variants of the pancreas?

1. Pancreatic divisum
2. Annular pancreas
3. Partial agenesis

5

Annular pancreas

Second part of duodenum is surrounded by a ring of pancreatic tissue that is continuous with the head of the pancreas
- may constrict duodenum
- rare condition

6

What should be included in the patients history? (3)

1. Previous episodes of pancreatitis or hospitalizations
2. Gallbladder intact or not
- surgery
3. Area of pain
- if patient exhibits discomfort while scanning over the pancreas area, this should be relayed to the radiologist

7

What is an indicator of pancreatitis?

Epigastric pain

8

When is the role of doppler used with the pancreas? (3)

1. If the splenic vein does not appear anechoic and is over distended
- colour and doppler should be used to ascertain patency and hepatopetal flow
2. Pancreatitis
3. Any masses seen

9

Hepatopetal

Flow towards the liver

10

What are some indications for a pancreatic scan? (8)

1. Severe epigastric pain
2. Elevated pancreatic enzymes
3. Biliary disease
4. Abdominal distension
5. Pancreatitis
6. Weight loss/anorexia
7. Pancreatic neoplasm
8. Evaluate mass seen on CT

11

Acute pancreatitis

An acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems associated with raised pancreatic enzyme levels in blood or urine

12

What are the top 2 causes/risk factors of acute pancreatitis?

1. Gallstones
2. Alcoholism

13

What are other causes of acute pancreatitis? (9)

1. Choledocholithiasis
2. Biliary sludge
3. Neoplasm
4. Infection
5. Toxins
6. Drugs
7. Genetic
8. Traumatic
9. Iatrogenic factors
- eg. endoscopy or post-operative

14

What are the steps for diagnosing acute pancreatitis? (2)

1. Amylase and lipase are elevated on blood tests
2. Patient is then sent for imaging to help confirm the diagnosis

15

What are the sonographic findings for acute pancreatitis? (2)

1. GB and bile ducts are assessed for stones
2. Enlargement of the pancreas also occurs

16

CECT

Contrast enhanced CT

17

What important to check when scanning the pancreas? (3)

1. Gallstones
2. Choledochalithiasis
3. Obstructions

18

What is US great at seeing?

The biliary system

19

How can acute pancreatitis appear?

1. Hypoechoic
2. Enlarged

20

Why does acute pancreatitis appear hypoechoic or enlarged?

Due to interstitial edema
- use AP measurements if suspected

21

Edema

Swelling of the tissue

22

What is the most common and useful finding to diagnose pancreatitis? (2)

1. Hypoechoic or anechoic collections that conform to the retroperitoneal or peritoneal space
2. Ascites or complex fluid

23

What are local complications of pancreatitis associated inflammation?

1. Acute fluid collections
2. Pseudocysts
- fluid collection persisting over 6 weeks
3. Abscess
4. Necrosis
5. Vascular Complications

24

What are 3 examples of vascular complications?

1. Hemorrhage
2. Venous thrombosis
3. Pseudoaneurysms

25

What do 40% of patients with acute pancreatitis develop?

Acute fluid collections

26

What does it mean when acute fluid collections contain debris or necrosis?

It can have an infection

27

Pseudocyst

Fluid collection that persists more than 6 weeks
- hard to tell the difference between this and a simple cyst (need more testing to confirm)

28

What is a pseudocyst considered?

Not a true cyst

29

Why is a pseudocyst not considered a true cyst?

Because it does not have an epithelial lining

30

Local complications

Complications that are close to the region that was infected