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Abdominal Pathology > Lesson 3A (Part 2) > Flashcards

Lesson 3A (Part 2) Flashcards

1
Q

What does it mean if the body of the pancreas exceeds 3cm AP?

A

Acute pancreatitis

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2
Q

How much should the pancreatic duct AP measurement be?

A

3mm or less

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3
Q

What is the most common variant of the pancreas?

A

Pancreatic divisum

- failure of fusion

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4
Q

What are 3 variants of the pancreas?

A
  1. Pancreatic divisum
  2. Annular pancreas
  3. Partial agenesis
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5
Q

Annular pancreas

A

Second part of duodenum is surrounded by a ring of pancreatic tissue that is continuous with the head of the pancreas

  • may constrict duodenum
  • rare condition
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6
Q

What should be included in the patients history? (3)

A
  1. Previous episodes of pancreatitis or hospitalizations
  2. Gallbladder intact or not
    - surgery
  3. Area of pain
    - if patient exhibits discomfort while scanning over the pancreas area, this should be relayed to the radiologist
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7
Q

What is an indicator of pancreatitis?

A

Epigastric pain

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8
Q

When is the role of doppler used with the pancreas? (3)

A
  1. If the splenic vein does not appear anechoic and is over distended
    - colour and doppler should be used to ascertain patency and hepatopetal flow
  2. Pancreatitis
  3. Any masses seen
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9
Q

Hepatopetal

A

Flow towards the liver

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10
Q

What are some indications for a pancreatic scan? (8)

A
  1. Severe epigastric pain
  2. Elevated pancreatic enzymes
  3. Biliary disease
  4. Abdominal distension
  5. Pancreatitis
  6. Weight loss/anorexia
  7. Pancreatic neoplasm
  8. Evaluate mass seen on CT
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11
Q

Acute pancreatitis

A

An acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems associated with raised pancreatic enzyme levels in blood or urine

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12
Q

What are the top 2 causes/risk factors of acute pancreatitis?

A
  1. Gallstones

2. Alcoholism

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13
Q

What are other causes of acute pancreatitis? (9)

A
  1. Choledocholithiasis
  2. Biliary sludge
  3. Neoplasm
  4. Infection
  5. Toxins
  6. Drugs
  7. Genetic
  8. Traumatic
  9. Iatrogenic factors
    - eg. endoscopy or post-operative
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14
Q

What are the steps for diagnosing acute pancreatitis? (2)

A
  1. Amylase and lipase are elevated on blood tests

2. Patient is then sent for imaging to help confirm the diagnosis

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15
Q

What are the sonographic findings for acute pancreatitis? (2)

A
  1. GB and bile ducts are assessed for stones

2. Enlargement of the pancreas also occurs

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16
Q

CECT

A

Contrast enhanced CT

17
Q

What important to check when scanning the pancreas? (3)

A
  1. Gallstones
  2. Choledochalithiasis
  3. Obstructions
18
Q

What is US great at seeing?

A

The biliary system

19
Q

How can acute pancreatitis appear?

A
  1. Hypoechoic

2. Enlarged

20
Q

Why does acute pancreatitis appear hypoechoic or enlarged?

A

Due to interstitial edema

- use AP measurements if suspected

21
Q

Edema

A

Swelling of the tissue

22
Q

What is the most common and useful finding to diagnose pancreatitis? (2)

A
  1. Hypoechoic or anechoic collections that conform to the retroperitoneal or peritoneal space
  2. Ascites or complex fluid
23
Q

What are local complications of pancreatitis associated inflammation?

A
  1. Acute fluid collections
  2. Pseudocysts
    - fluid collection persisting over 6 weeks
  3. Abscess
  4. Necrosis
  5. Vascular Complications
24
Q

What are 3 examples of vascular complications?

A
  1. Hemorrhage
  2. Venous thrombosis
  3. Pseudoaneurysms
25
Q

What do 40% of patients with acute pancreatitis develop?

A

Acute fluid collections

26
Q

What does it mean when acute fluid collections contain debris or necrosis?

A

It can have an infection

27
Q

Pseudocyst

A

Fluid collection that persists more than 6 weeks

- hard to tell the difference between this and a simple cyst (need more testing to confirm)

28
Q

What is a pseudocyst considered?

A

Not a true cyst

29
Q

Why is a pseudocyst not considered a true cyst?

A

Because it does not have an epithelial lining

30
Q

Local complications

A

Complications that are close to the region that was infected

Abdominal Pathology (49 decks)

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