Pancreas Flashcards
(17 cards)
What is the blood supply of pancreas ?
Superior and inferior pancreaticoduodenal arteries
Branch of gastroduodenal artery and superior mesentric artery respectively
Splenic artery for body and tail
Pancreaticoduodenal veins -> superior mesentric veins -> pancreatic veins -> splenic veins -> portal vein .
Lymphatic drainage of pancreas ?
Pancreaticoduodenal ln
Drain into celiac and superior mesentric lymph node
Body to pancreaticospenic lymph nodes drain to celiac and superior mesentric lymph nodes
Causes of acute pancreatitis
I get smashed
Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Sjogren
Hypocalcemia
Ecf
Drugs
How do gall stones cause acute pancreatitis ?
1.Gall stones block the ampulla of vater , increase pressure in pancreatic duct and cause premature enzymes release and pancreatic injury
2. Reflux into pancreatic duct due to obstruction .
How is Alcohol induced pancreatitis occurring ?
Alcohol mediates oxidative stress that cause release of inflammatory factors and release of tnf alpha , also there is pancreatic edema .
Smoking promotes pancreatic injury .
Ercp induced pancreatitis risk factors
Endoscopic retrograde cholangiopancreaticography
R/f :
Male
Young age
Sphincter of odii dysfunction
Multiple cannulation attempts , contrast injection , therapeutic procedures in diagnosis .
Drug’s inducing pancreatitis ?
Labetalol
Tetracycline
Thiazide
5 amino salicylic acid
What is the investigation of choice in ap ?
Cect abdome
Clinical features
Pain , signs of dehydration
Mild moderate acute pancreatitis tt
Iv fluids
Give antibiotics o my if superadded infection is there
Why eras and what is the principal ?
Eras means enhanced recovery after surgery ,
🥰 early nutrition
🥰NPO leads to translocation of good bacteria
🥰that leads to immunity decrease
🥰entrap nutrition is more better than parentral nutrition
Ercp
Endoscopic retrograde cholangiopancreaticography
❤️abp patients
❤️cbd obstruction
❤️sphincterectomy done
Lap cholecystectomy
In abp
Performed within 96 hrs of admission or after 6 weeks , will reduce the complications .
Stones without obstruction
If pain and severe then cholecystectomy
Complications
Acute necrotic collection
Acute peripancreatic fluid collection
Walled off necrosis
Pseudocyst
.
What is necrostomy
💘Necrosectomy necrosed part of pancreas removed
💘Necrostomy necroses head of pancreas removed
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