Fiser: Pancreas

Question 1

Whats the difference between a pseudocyst and a regular cyst?

Answer 1

pseudocysts lack an epithelial lining, the capsule in a pancreatic pseudocyst is fibrosis from inflammation of surrounding tissue

Question 2

what is the puestow procedure? when indicated?

Answer 2

Longitudinal pancreaticojejunostomy: patients w refractory chronic pancreatitis and dilated main pancreatic duct >8mm

Question 3

what is a frey procedure?

Answer 3

resecting the head of the pancreas and drainage via pancreaticojejunostomy, used in patients w ductal dilatation localized to the head and body of the pancreas

Question 4

what is the berger procedure?

Answer 4

resection of the pancreatic head with preservation of the duodenum, a sleeve of panc head tissue remain behind (uncommonly performed)

Question 5

describe technique of how you open pancreatic duct in puestow procedure?

Answer 5

open duct anteriorly along length, medially to the GDA and laterally into the tail beyond all pancreatic duct strictures

Question 6

What’s ransons criteria?

Answer 6

Presentation: 
age >55
WBC >16
Glucose >200
AST > 250
LDH >350
After 48hrs: Hct decreased by 10%, BUN increased of 5, Ca <8, PaO2 <60, base deficit >4, fluid sequestration >6L

Question 7

most important risk factor for necrotizing pancreatitis?

Answer 7

obesity

Question 8

ARDS in setting of pancreatitis is related to what?

Answer 8

release of phospholipases

Question 9

coagulopathy in setting of pancreatitis is related to what?

Answer 9

release of proteases

Question 10

management of pancreatic cysts not associated with pancreatitis?

Answer 10

resection! may be IPMN or mucinous cystadenocarcinoma

Question 11

MCC splenic vein thrombosis?

Answer 11

chronic pancreatitis

Question 12

tx of isolated bleeding gastric varices?

Answer 12

splenectomy (most likely 2/2 splenic vein thrombosis)

Question 13

what mutation is diagnostic for hereditary pancreatitis?

Answer 13

PRSS1