Chronic Pancreatitis

Question 1

When does chronic pancreatitis occur

Answer 1

Recurrent attacks cause destruction and permanent damage

Question 2

Chronic pancreatitis is….

Answer 2

Asymptomatic longer
May present with fibrotic mass
Symptoms of pancreatic insufficiency
Serum amylase and lipase are usually normal 
Patchy focal fibrotic disease

Question 3

Appearance of chronic pancreaititis

Answer 3

Patchy focal fibrotic disease

Question 4

Symptoms of Chronic pancreatitis

Answer 4

Abdominal pain  epigastric, radiating to the back
Nausea & vomiting
Pancreatic insufficiency
Severe exocrine disfunction  digestion problems
Glucose intolerance

Question 5

what is chronic pancreatitis associated with

Answer 5

Chronic alcoholism
Biliary disease
Hypercalcemia
Hyperlipidemia

Question 6

Chronic pancreatitis results from

Answer 6

Recurrent attacks of acute pancreatitis

causes continuing destruction of the pancreatic parenchyma

Question 7

What is chronic pancreatitis associated with

Answer 7

Chronic alcoholism and biliary disease

Question 8

Complications associated with chronic pancreatitis

Answer 8

Patient may also have pseudocysts (25% to 40%),a dilated common bile duct, or thrombosis of the splenic vein with extension into the portal vein; increases risk of patient developing pancreatic cancer.

Question 9

Sonographic appearance of chronic pancreatitis

Answer 9

“•Gland is small and fibrotic
•Irregular borders
•Mixed echogenicity (hypoechoic from inflammation and hyperechoic foci)
•Dilated pancreatic duct (string of pearls sign wth dilated duct)
•Calcifications
•Calculi within the duct”

Question 10

What are some complications of pancreatitis

Answer 10

Walled-off pancreatic fluid collections
Bile duct or duodenal obstruction
Pancreatic ascites
Pleural effusion
Splenic vein thrombosis
Pseudoaneurysms
Pancreatic cancer

Question 11

Walls off pancreatic fluid

Answer 11

Acute peripancreatic fluid collections
Pseudocysts
Acute necrotic collections
Walled-off pancreatic necrosis

Question 12

walled out Pancreatic fluid

Answer 12

Abdominal pain
Duodenal or biliary obstruction
Vascular occlusion
Fistula formation into adjacent viscera, the pleural space, or pericardium

Question 13

Pancreatic pseudocyst

Answer 13

Acute or chronic

Trauma to gland

Question 14

Walled off necrotic intrahepatic or extrahepatic fluid collections

Answer 14

Rupture

Pancreatic Ascites

Question 15

Grey turners sign

Answer 15

subcutaneous manifestation of intra-abdominal pathology that manifests as ecchymosis or discoloration of the flanks.

Question 16

Hemorrhagic pancreatitis

Answer 16

Rapid progression of acute pancreatic with the rupture of pancreatic vessels and subsequent hemorrhage

Question 17

Enzymes cause what

Answer 17

focal areas of fat necrosis in and around the pancreas which leads to rupture of pancreatic vessels and hemorrhage

Question 18

Phlegmonous Pancreatitis

Answer 18

A phlegmon is an inflammatory process that spreads along fascial pathways, causing localized areas of diffuse inflammatory edema of soft tissue that may proceed to necrosis and suppuration.

Question 19

what does phlegmonous pancreatitis involve

Answer 19

Involves the lesser sac, left anterior pararenal space, and transverse mesocolon