Flashcards in Pancreas and Peritoneal Deck (36):
What results from the failure of dorsal and ventral pancreatic duct fusion?
What is defined as a bandlike ring of normal pancreatic tissue completely encircling the second portion of the duodenum?
What is an ectopic pancreas?
Pancreatic tissue found in the stomach, duodenum, jejunum, meckel's diverticulum, and ileum. Usually very small
How do acute pancreatitis and chronic pancreatitis differ grossly?
Acute pancreatitis: Necrosis
Chornic pancreatitis: Fibrosis
How does chronic pancreatitis lead to pancreatic insufficiency?
Irreversible loss of acinar tissue
What pancreatitis may mimic pancreatic cancer on gross specimen?
Type I autoimmune pancreatitis
What is the histological problem in type I autoimmune pancreatitis?
IgG4 producing plasma cell increase
How do you treat autoimmune pancreatitis?
What are other diseases which may be manifestations of IgG4 disease?
Type 1 autoimmune pancreatitis
Chronic sclerosing sialadenitis (Kuttner's tumor) : a salivary gland tumor
What disease is analogous to sarcoidosis in its systemic organ manifestations by the same histopathological features?
IgG4 related disease
What are the two most common causes of pancreatic pseudocysts?
What enzyme levels are high in pancreatic pseudocysts?
What does the microscopic appearance of a pancreatic pseudocyst look like?
Lacks true epithelial lining and instead is lined by fibrin and granulation tissue
A older gentleman comes into your office with abdominal pain. A pancreatic tumor is resected, and his tumor had cysts with straw-colored fluid in them. It was a curative resection. What was the cyst?
A middle aged woman comes into your office with a mass in her belly that was painless. A cyst was removed from the tail of her pancreas. What is the likely cause? What do you have to worry about?
Worry about malignancy
An older gentleman comes into your office with a bump in his belly that was painless. CT examination shows a dilated duct system in the pancreas. What is the likely diagnosis and what do you have to worry about?
Intraductal papillary mucinous neoplasm
Worry about malignancy
Where does pancreatic cancer rank in the list of causes of cancer deaths?
Fourth leading cause
What are risk factors for pancreatic carcinoma?
What are common clinical presentations of pancreatic carcinoma?
Pain, jaundice, cachexia, thrombophlebitis
How is pancreatic carcinoma diagnosed?
Imaging study, tissue bx
Often with endoscopic ultrasound guided biopsy technique
What is the whipple procedure?
Transect pancreas, take out duodenum and bile duct.
Attach stomach to jejunum, hepatic duct to jejunum, and pancreas to duodenum
What pancreatic cancer is most common in children?
What cancer is most likely to be found in a young woman?
Pancreatic solid-pseudopapillary tumor
Where are pancreatic neuroendocrine tumors usually found? What about pancreatic adenocarcinoma?
PNT: body or tail
What do pancreatic neuroendocrine tumors look like? What about pancreatic adenocarcinoma?
PNT: Well circumscribed
PA: not well circumscribed
What is the clinical course of pancreatic neuroendocrine tumors like? What about pancreatic adenocarcinoma?
PNT: Long clinical course
PA: 1 year
What are some hormones that are released by pancreatic neuroendocrine tumors?
What are some common causes of peritonitis?
Hemorrhagic necrotizing pancreatitis
Endometriosis (localized hemorrhage)
What is defined as excess fluid in the peritoneal cavity?
What is the most common cause of ascites? Second most common?
What is the most significant complication of ascites?
Spontaneous bacterial peritonitis (bacterial infection without known source)
Why do you do a cell count with ascites?
Cell count: infection
Albumin: for serum ascites-albumin gradient
Total protein: if protein rich, then exudate
If the SAAG is <1.1, what are the most likely causes of the ascites?
If the SAAG is >1.1, what are the most likely causes of the ascites?
What two metastatic tumors are the most common causes of malignant ascites?
Ovarian carcinoma: #1
Pancreatic carcinoma: #2