GI Section VI: PANCREAS (Misc Trivia)

Question 1

Trivia regarding the pancreas can be broadly clustered into:

Answer 1

SOLID lesions
CYSTIC lesions
PANCREATITIS
MISC TIVIA (Mostly Dev’ stuff)

Question 2

Classic US trivia:

The Pancreatic Echogenicity should be ____ than the normal liver.

Answer 2

The Pancreatic Echogenicity should be GREATER than the normal liver.

Question 3

Classic MRI trivia:

The Pancreas should be ___ on non contrast T1.

Answer 3

The brightest organ in T1

Question 4

You can see the pancreas in what part of the abdomen?

Answer 4

Retroperitoneum (except the TAIL - intraperitoneal)

Question 5

The pancreas is involved in 85-90% of what cases?

why?

Answer 5

Cystic Fibrosis

Inspissated secretions cause proximal duct obstruction

Question 6

Inspissated secretions cause proximal duct obstruction leading to these 2 changes in Cystic fibrosis

Answer 6

1. Fibrosis (Low T1 and T2
2. Fatty replacement (hight T1) - more common

Question 7

is the most common imaging finding in adult CF

Answer 7

Complete fatty replacement

Question 8

Markedly enlarged with fatty replacement has been termed:

Answer 8

Lipomatous pseudohypertrophy of the pancreas

Question 9

Wall thickening
of the proximal colon as a complication of enzyme replacement therapy.

Answer 9

Fibrosing Colonopathy

Question 10

Answer 10

Cystic fibrosis

Complete fatty replacemento of the pancreas

Question 11

The 2”^ most common cause of pancreatic insufficiency in kids (CF #1).

Answer 11

Shwachman-Diamond Syndrome

Question 12

Kids + Diarrhea + short (metaphyseal chondroplaisa) + ecema

Answer 12

Shwachman-Diamond Syndrome

Question 13

Answer 13

Lipomatous pseudohypertrophy of the pancreas

Increased T1

Question 14

Most common pathologic condition involving the pancreas.

Answer 14

Pancreatic Lipomatosis

Most common in kids = Cystic Fibrosis

Question 15

Pancreatic Agenesis vs Pancreatic-Lipomatosis

Does NOT have a duct =

Does HAVE a duct =

Answer 15

Does NOT have a duct = Agenesis

Does HAVE a duct = LIpomatosis

Question 16

Dorsal Pancreatic Agenesis

Answer 16

1. sets you up for diabetes (most o fyour beta cells are in the tail)
2. Polysplenia

Question 17

Annular pancreas

Answer 17

failure of ventral bud to rotate with the duodenum = encasement of the duodenum

Question 18

Answer 18

Annular pancreas

Children = duodenal obstruction (10%)
Adults = pancreatitis

Question 19

Annular pancreas symptoms

Answer 19

Post-prandial fullness, “peptic ulcer disease”

Question 20

The only thing that matters in Pancreatic trauma

Answer 20

Integrity of the duct

Question 21

If the duct is damaged in Pancreatic trauma =

Answer 21

Surgery is needed.

Complication = fistula (10-20%), abscess

Question 22

Signs of pancreatic injury

Answer 22

Focal pancreatic enlargement or adjacent straning/fluid

Question 23

Answer 23

Pancreatic trauma - Laceration

low attenuation fluid separating two portions of the enhancing pancreatic

Question 24

Traumatic Pancreatitis in a kid too young to ride a bike

Answer 24

Non-accidental trauma (NAT)

Question 25

Next step in suspected Pancreatic Duct Injury

Answer 25

MRCP or ERCP