Lange - Liver/gall Bladder/pancreas Flashcards
Annular pancreas associated with?
Down syndrome
Choledochal cyst associated with?
Cholangiocarcinoma
Patient with SBO and air in biliary tree suggests?
Gallstone ileus
Patient with history of liver trauma who develops G.I. bleeding weeks later – suspected diagnosis? Confirm and treat with?
Hemobilia
Angiography and embolization
Point of HIDA scan?
Patency of cystic duct
Needle biopsy of liver mass is contraindicated if mass is believed to be?
Hepatic adenoma
Classes of the splenic injury? Management?
Class I – non-expanding subcapsular hematoma (Non-operative management)
Class II – laceration 1-3 cm deep (Non-operative management)
Class III – major parenchymal injury (operate)
VIPoma presents with? Management?
WDHA – watery diarrhea, hypokalemia, achlorhydra (And metabolic acidosis)
Octreotide (decreases diarrhea) and excision of tumor
Felty’s syndrome? Possible tx?
Rheumatoid arthritis, neutropenia, splenomegaly
Splenectomy
Anechoic area (on US) of liver suggestive of?
Benign, non-parasitic cyst
Treatment of pseudocyst? If fails?
Usually self resolves
If enlarges, Percutaneous drainage
If unsuccessful, internal drainage into stomach
Why could serum amylase be normal in pancreatitis?
- Hyperlipidemia (Interferes with chemical detection of Amylase)
- Increased urinary excretion
- Destruction of pancreatic parenchyma (chronic pancreatitis)
Causes for serum amylase to be elevated in absence of pancreatitis?
- Perforated peptic ulcer
- Gangrenous cholecystitis
- Small bowel strangulation
- Chronic renal failure
Most common site of trauma to the pancreas?
Neck
When to perform:
- Pancreaticojejunostomy (Puestow)
- Whipple procedure
- Distal pancreatectomy
- Pancreatitis with dilated pancreatic ducts and persistent symptoms after ERCP
- Disease confined to head pancreas
- Disease involves body and tail of pancreas