Pancreaticobiliary pathology Flashcards
80% of those with primary sclerosing cholangitis also have what condition?
Ulcerative colitis
90% of all pancreatic tumours are…. ?
Ductal adenocarcinoma
What is a pancreatic pseudocyst?
A localised collection of pancreatic secretions
it is a complication of chronic pancreatitis
How does chronic pancreatitis present?
Episodic abdominal pain (recurrent pancreatitis)
Maldigestion
Diabetes Mellitus
Occasional jaundice
What are the 3 main mechanisms causing acute pancreatitis?
1) Duct obstruction
2) Acinar cell injury
3) Defective intracellular transport
All of these lead to acinar cell injury and activated enzymes.
How do we diagnose acute pancreatitis?
3-4 fold increase in plasma lipase (48hrs) or amylase (24hrs)
What are the symptoms of acute pancreatitis?
Severe epigastric pain
Nausea and vomiting
Peritonitis +/- shock
What is pancreatitis caused by?
Enzymatic auto-digestion of pancreatic tissue
can be acute or chronic
What are the complications of cholecystitis?
Cholangitis, sepsis, abscess formation, peritonitis, infection,
perforation, decompensation of pre-existing disease.
Symptoms of cholecystitis?
ACUTE: Transient RUQ pain Fever Rarely jaundice unless duct obstruction Murphy's sign usually positive.
CHRONIC:
Often asymptomatic or repeated bouts of acute pain.
What is cholecystitis?
Acute or chronic inflammation of the gallbladder- 90% associated with gallstones.
Differentiate black vs brown pigment stones
Black- sterile bile
Brown- infected bile
What are 20% of gallstones made of?
Pigment stones.
Black or brown stones.
What are gallstones?
The majority are cholesterol with small amounts of calcium salts +- bilirubin.
What happens if there is a gallstone in the common bile duct?
Chile stasis, jaundice, cholangitis, pancreatitis