chronic pancreatitis Flashcards
what is it
persistent chronic inflammation often due to repeated bouts of acute pancreatitis or insidiously developing
pathology
healthy tissue replaced by misshapen ducts fibrosis and Ca deposits due to chronic inflammation
outline the effect alcohol has on th pancreas
impairs calcium regulation leading to inc levels - Ca deposit
what may inflammation and fibrosis mimic in the head of the pancreas
cancer
how does smoking affect the disease
inc the advancement
what happens to acinar and islet cells
destruction
consequences of destruction acinar cells
produce fewer digestive enzymes - pancreatic insufficiency
cant absorb fat as well - weight loss and deficiency in ADEK (fat soluble vitamins)
fat may pass undigested - steatorrhoea
causes
alcohol
hereditary - alpha 1 antitrypsin deficiency and CF
gallstones
tropical countries - areas deficient in methionine, zinc and selenium
hyperparathyroidism
malnourishment
familial
pancreatic duct obstruction
what is the main cause of chronic pancreatitis in kids
CF
how does hyperPTH cause chronic pancreatitis
inc levels of blood Ca
O/E
tenderness, peritoneum, mass, ascite, jaundice abdominal pain in epigastric region which may radiate to back
imaging - CT
show calcification, dilated pancreatic duct, intrapancreatic fluid collection
imaging - XR
show calcification
imaging - ERCP
can imagine ducts and see structural changes
complications
develop diabetes mellitus - islet cells
pseudocyst - lead to pseudo aneurysms
pancreatic cancer
bile duct obstruction
ascites and pleural effusion
splenic vein thrombosis