GI Section VI: PANCREAS (Misc Trivia) Flashcards
Trivia regarding the pancreas can be broadly clustered into:
SOLID lesions
CYSTIC lesions
PANCREATITIS
MISC TIVIA (Mostly Dev’ stuff)
Classic US trivia:
The Pancreatic Echogenicity should be ____ than the normal liver.
The Pancreatic Echogenicity should be GREATER than the normal liver.
Classic MRI trivia:
The Pancreas should be ___ on non contrast T1.
The brightest organ in T1
You can see the pancreas in what part of the abdomen?
Retroperitoneum (except the TAIL - intraperitoneal)
The pancreas is involved in 85-90% of what cases?
why?
Cystic Fibrosis
Inspissated secretions cause proximal duct obstruction
Inspissated secretions cause proximal duct obstruction leading to these 2 changes in Cystic fibrosis
- Fibrosis (Low T1 and T2
- Fatty replacement (hight T1) - more common
is the most common imaging finding in adult CF
Complete fatty replacement
Markedly enlarged with fatty replacement has been termed:
Lipomatous pseudohypertrophy of the pancreas
Wall thickening
of the proximal colon as a complication of enzyme replacement therapy.
Fibrosing Colonopathy
Cystic fibrosis
Complete fatty replacemento of the pancreas
The 2”^ most common cause of pancreatic insufficiency in kids (CF #1).
Shwachman-Diamond Syndrome
Kids + Diarrhea + short (metaphyseal chondroplaisa) + ecema
Shwachman-Diamond Syndrome
Lipomatous pseudohypertrophy of the pancreas
Increased T1
Most common pathologic condition involving the pancreas.
Pancreatic Lipomatosis
Most common in kids = Cystic Fibrosis
Pancreatic Agenesis vs Pancreatic-Lipomatosis
Does NOT have a duct =
Does HAVE a duct =
Does NOT have a duct = Agenesis
Does HAVE a duct = LIpomatosis
Dorsal Pancreatic Agenesis
- sets you up for diabetes (most o fyour beta cells are in the tail)
- Polysplenia
Annular pancreas
failure of ventral bud to rotate with the duodenum = encasement of the duodenum
Annular pancreas
Children = duodenal obstruction (10%)
Adults = pancreatitis
Annular pancreas symptoms
Post-prandial fullness, “peptic ulcer disease”
The only thing that matters in Pancreatic trauma
Integrity of the duct
If the duct is damaged in Pancreatic trauma =
Surgery is needed.
Complication = fistula (10-20%), abscess
Signs of pancreatic injury
Focal pancreatic enlargement or adjacent straning/fluid
Pancreatic trauma - Laceration
low attenuation fluid separating two portions of the enhancing pancreatic
Traumatic Pancreatitis in a kid too young to ride a bike
Non-accidental trauma (NAT)
Next step in suspected Pancreatic Duct Injury
MRCP or ERCP
