acute/chronic pancreatitis Flashcards
endocrine function of the pancreas
insulin and glucagon production
explain endocrine function
islets of Langerhans secrete several hormones directly into the blood stream
exocrine function
enzyme secretion
what cells produce enzymes
acinar cells
how do the enzymes get to the food
pancreatic duct to the duodenum
acute pancreatitis causes
I: idiopathic, G: gallstones, E: ethanol (alcohol), T: trauma, S: steroids, M: mumps, A: autoimmune, S: scorpion stings/spider bites, H:hyperlipidaemia/hypercalcaemia/hyperparathyroidism, E: ERCP, D: drugs
examples of drugs causeing AP
azathioprine, oestrogens, corticosteroids, didanosine
causes of CP
alcohol
Autoimmune (IgG4-related)
idiopathic
hereditory
hereditory CP
CF
final common pathway of AP
elevation in intracellular calcium = activation of intracellular proteases and release of pancreatic enzymes, acinar cell injury and necrosis follows = migration of inflammatory cells
AP symptoms
upper epigastric pain which radiates to the back
nausea and vommitting
AP signs
Cullen’s sign
Grey Turner’s sign
what does cullens sign or grey turners sign mean
necrotizing pancreatitis
Ecchymoses around the umbilicus
cullens
Ecchymoses in the flanks
grey turners
what in the blood test indicates AP
raised serum amylase or lipase
test for perforated peptic ulcer
chest X ray
AP complications
hyperglycaemia, hypocalcaemia, renal failure
and shock
chronic pancreatitis pathophys
Inappropriate activation of enzymes in pancreas = protein plugs in duct lumen = nidus for calcification. Subsequent duct blockage = ductal hypertension + pancreatic damage, cytokine activation = pancreatic inflammation, irreversible morphological change and impairment of function
clinical features of CP
intermittent or constant radiating through to the back weight loss Diabetes steatorrhoea jaundice
why might you be jaundiced in CP
obstruction of the CBD
Cancer affecting the head of the pancreas or ampulla of Vater clinical features
painless jaundice weight loss scratch marks distended, palpable gall bladder central abdominal mass
Cancer of the body or tail clinical presentation
abdominal pain, weight loss, diabetes
pancreas diagnosis is made with
US
contrast-enhanced spiral CT
