Lesson 3A (Part 3) Flashcards Preview

Abdominal Pathology > Lesson 3A (Part 3) > Flashcards

Flashcards in Lesson 3A (Part 3) Deck (28)
Loading flashcards...
1

What is the sonographic appearance of a pseudocyst?

Almost purely cystic to collections with considerable mural irregularity, septations and internal echogenic debris

2

What can cause the mural irregularity, septations and internal echogenic debris for a pseudocyst? (3)

1. Necrosis
2. Hemorrhage
3. Infection

3

Significant pancreatic necrosis

Parenchyma that is over 3cm AP or involving more then 30% of the pancreas

4

How is significant pancreatic necrosis treated? (2)

1. Antibiotics
2. Close observations

5

What is useful when diagnosing necrosis?

CECT
- US cant be done on its own

6

Why do abscesses occur?

If fluid collection becomes infected
- pus filled collections

7

What can you do with pseudocysts that become infected?

Drained or excised

8

What are considered the 2 most useful modalities when diagnosing acute pancreatitis?

1. CECT
- contrast enhanced CT
2. Abdominal Ultrasound

9

What are useful but usually secondary modalities when diagnosing acute pancreatitis? (2)

1. MRCP
2. MRI

10

What does the choice of modality depend on?

The patients clinical situation

11

When is CECT recommended?

Diagnostic for necrosis

12

When is CT recommended?

For determining delayed complications of acute pancreatitis, guiding aspiration and drainage

13

When is US recommended?

When assessing fluid collections, biliary systems and dilated ducts

14

What modality do you use if this is the patients first episode of acute pancreatitis?

Ultrasound

15

What modality do you use if this is the patients second episode of acute pancreatitis?

CT

16

What is ERCP usually used for?

Therapy
- not diagnosis

17

What can US and CECT be used for in treatment?

1. Guidance aspiration
2. Drain an infected pseudocyst

18

Chronic pancreatitis

Intermittent pancreatic inflammation with progressive irreversible damage to the gland

19

What is the predominant cause of chronic pancreatitis?

Alcoholism

20

What are other causes of chronic pancreatitis? (6)

1. Pancreatic duct obstruction
2. Hypertriglyceremia
3. Hypercalcemia
4. Auto-immune pancreatitis
5. Tropical pancreatitis
6. Genetic mutations

21

What are signs and symptoms of chronic pancreatitis? (3)

1. Pain
2. Malabsorption
3. Diabetes

22

What can chronic pancreatitis lead to? (6)

1. Fibrosis
2. Cellular damage
3. Chronic inflammation
4. Distorted/blocked ducts
5. Permanent structural changes
6. Deficient endocrine and exocrine function

23

What is the sonographic appearance of chronic pancreatitis? (5)

1. Altered parenchymal texture
2. Glandular atrophy
- or gland enlargement
3. Focal masses
4. Dilation and beading of pancreatic duct with calcifications
5. Pseudocysts

24

What is the treatment for uncomplicated chronic pancreatitis? (2)

1. Alleviate pain
2. Control malabsorption and diabetes

25

What is the goal of uncomplicated chronic pancreatitis treament?

Aim to improve quality of life

26

What is the treatment for complicated chronic pancreatitis? (2)

1. Surgery
2. Endoscopy

27

What are possible complications with treatment of complicated chronic pancreatitis? (5)

1. Pseudocysts
- more common in chronic
2. Abscesses
3. Malignancies
4. Thrombosis of portals
5. Pancreatic and bile duct obstruction
- double duct sign

28

Which is more likely to cause more damage, acute or chronic pancreatitis?

Chronic pancreatitis