Hepatic System: Pancreatic Cancer and Peritonitis Flashcards
Pancreatic cancer is one of the most deadly. What is the mortality forecast post-dx?
• 3-5mos
Which part of the pancreas is cancer more common in?
• Head
How is cancer in the head of the pancreas resolved surgically?
• The Whipple procedure
Describe the Whipple procedure.
- Surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes.
- The remaining pancreas is then attached to the end of the remaining intestine (and cut of the duodenum) and then the liver is attached a little further down the intestine
What are the risk factors for pancreatic cancer?
- Age
- Smoking
- *Red meat diet
- *Male
- *Black
- *DM
- *Chronic pancreatitis
- *Cirrhosis
- Obesity
- Family hx
For those that have had a pancreas removal, what will be a life long result they will have to manage?
- They will need to take digestive enzymes for the rest of their life
- They will need to inject insulin
What are s/s of the lack of digestive enzymes?
- ↓ weight
* ↑ fatty stool
A pt that has had their pancreas removed will be connected to multiple sumps. Name and describe each.
• NG Tube o Gastric decompression to avoid vomiting and suture rupture • Jejunostomy tube o For feeding • Two drainage sumps (one for each side) o To drain peritoneal fluids while healing • Irrigation tube o For peritoneal cleaning
What is peritonitis?
• Inflammation of the peritoneum
What are some causes of peritonitis?
- Hepatitis
- Organs in or around the peritoneal cavity (anything GI, Hepatic or Renal) that perforate or become infected
- Abdominal wound or injury
- Invasive procedures
What are the s/s of peritonitis?
- Abdominal tenderness (all over)
- Abdomen pain that gets more intense w/ movement or touch
- Bloating/distension
- Rebound tenderness
- N/V/D/C, inability to flatulate
- Loss of appetite
- Minimal urine OP
What is the non-surgical tx for peritonitis?
- NPO
- NG tube
- IV fluids
- Abx
- Analgesics
Why can peritonitis spread throughout the abdomen so quickly?
• Due to the greater omentum that extends down from the stomach covering much of the colon ands small intestines
What is the surgical tx for peritonitis?
- Repair/removal of perforated organ
* Intraabdominal lavage (washing out body cavity w/ water or medicated solution)