Hepatic System: Pancreatic Cancer and Peritonitis Flashcards

1
Q

Pancreatic cancer is one of the most deadly. What is the mortality forecast post-dx?

A

• 3-5mos

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2
Q

Which part of the pancreas is cancer more common in?

A

• Head

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3
Q

How is cancer in the head of the pancreas resolved surgically?

A

• The Whipple procedure

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4
Q

Describe the Whipple procedure.

A
  • 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
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5
Q

What are the risk factors for pancreatic cancer?

A
  • Age
  • Smoking
  • *Red meat diet
  • *Male
  • *Black
  • *DM
  • *Chronic pancreatitis
  • *Cirrhosis
  • Obesity
  • Family hx
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6
Q

For those that have had a pancreas removal, what will be a life long result they will have to manage?

A
  • They will need to take digestive enzymes for the rest of their life
  • They will need to inject insulin
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7
Q

What are s/s of the lack of digestive enzymes?

A
  • ↓ weight

* ↑ fatty stool

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8
Q

A pt that has had their pancreas removed will be connected to multiple sumps. Name and describe each.

A
•	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
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9
Q

What is peritonitis?

A

• Inflammation of the peritoneum

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10
Q

What are some causes of peritonitis?

A
  • Hepatitis
  • Organs in or around the peritoneal cavity (anything GI, Hepatic or Renal) that perforate or become infected
  • Abdominal wound or injury
  • Invasive procedures
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11
Q

What are the s/s of peritonitis?

A
  • 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
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12
Q

What is the non-surgical tx for peritonitis?

A
  • NPO
  • NG tube
  • IV fluids
  • Abx
  • Analgesics
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13
Q

Why can peritonitis spread throughout the abdomen so quickly?

A

• Due to the greater omentum that extends down from the stomach covering much of the colon ands small intestines

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14
Q

What is the surgical tx for peritonitis?

A
  • Repair/removal of perforated organ

* Intraabdominal lavage (washing out body cavity w/ water or medicated solution)

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