Exocrine Pancreas

Question 1

Annular Pancreas

Answer 1

pancreas forms a ring around the duodenum

Question 2

Acute Pancreatitis

Answer 2

inflammation and hemorrhage of the pancreas due to autodigestion by pancreatic enzymes causing liquefactive hemorrhagic necrosis of the pancreas and fat necrosis of the peripancreatic fat

• clinical features: pain radiating to back, elevated lipase and amylase, hypocalcemia
• complications: shock, pseudocyst, abscess, DIC, ARDS

*trypsin- activated first

Question 3

Chronic Pancreatitis

Answer 3

fibrosis of pancreatic parenchyma from alcohol or CF causing pain radiating to back, pancreatic insufficiency, dystrophic calcification of parenchyma

Question 4

Pancreatic Carcinoma

Answer 4

adenocarcinoma of pancreatic ducts due to smoking or chronic pancreatitis causing abdominal pain, weight loss, pale stools, palpable gallbladder, secondary DM, pancreatitis, Trousseau syndrome (migratory thromboplebitis)

• CA19-9= serum tumor marker
• treatment= Whipple procedure (removal of head and neck of pancreas, proximal duodenum and gallbladder