Pancreas Flashcards
Where does the pancreas lie?
-Retroperitoneal structure that lies between the duodenal loop and the splenic hilum
What is the pancreas divided into?
- uncinated process
- neck
- body
- tail
What is the pancreas exocrine function?
Secrete trypsin, lipase, and amylase through the ductal system.
What is the pancreas endocrine function?
Secrete insulin though the islets of Langerhans
What is the normal measurement of the pancreas?
< 3 cm anterior to posterior
What is the head of the pancreas anterior to?
IVC
What is the head of pancreas medial to?
Duodenum
What is the CBD posterior / lateral to?
Pancreatic head
The gastroduodenal artery is what in relation to pancreatic head?
Anterior / lateral
What is posterior to the neck of the pancreas?
SMA and SMV
What is anterior to the uncinated process?
SMA and SMV
The body of the pancreas is anterior to what?
Aorta
Where is the celiac axis in reference to the pancreas?
Superior border of the pancreas
Where is the SMA in reference to the pancreas?
Inferior border
What are the branches off the celiac axis?
- Hepatic Artery
- Left gastric artery which divides into the common hepatic artery and the splenic artery
Where is the splenic artery in reference to the pancreas?
Superior border of the body and tail of pancreas
What is the right gastric artery a branch off of?
Proper hepatic artery
What does the GDA divide into?
- right gastroepiploic artery
- superior pancreaticoduodenal artery
Where is the splenic vein in reference to the pancreas?
posterior pancreatic tail
What makes up the MPV?
Splenic vein and SMV
What is the accessory pancreatic duct?
Duct of Santorini
What is the main pancreatic duct?
Duct of Wirsung
What is the normal measurement for pancreatic ducts?
< 2 mm
What are all the structures intact with the pancreatic head?
- IVC
- CBD
- Ampulla of Vater
- GDA
- C loop of duodenum
What is Acute pancreatitis?
Inflammation disease producing temporary pancreatic changes
- most common cause is alcoholism and gallstones
Know about chronic pancreatitis…
Irreversible destruction due to repeated bouts of pancreatic inflammation
What is the most common cause for pancreatitis?
Alcoholic chronic pancreatitis
What labs will be elevated in pancreatitis?
- serum amylase
- lipase
Know about pancreatic cysts…
- true cysts are very rare
- associated with polycystic kidney disease
- associated with von Hippel-Lindau syndrome
What is Cystic Fibrosis?
Exocrine gland disorder resulting in viscous secretions causing pancreatic dysfunction
- meconium ileus is a common associated with condition
What are some findings for cystic fibrosis?
- increased pancreatic echogenicity
- gland atrophy
- fibrosis and fatty replacement
- cysts due to ductal obstruction
What is a pancreatic pseudocyst?
accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum
Where does the fluid enter in a pseudocyst?
Lesser sac
What is a Pancreas Divisum?
Failure of the dorsal and ventral pancreatic ductal systems to fuse during embryonic development resulting in the smaller Santorini’s duct draining the pancreas
What is an Annular Pancreas?
congenital anomaly where the ventral pancreas encircles the second portion of the duodenum
- present as “double-bubble” sign, dilated stomach and duodenal bulb
Know about Pancreatic Adenocarcinoma…
when found, too late. Fatal disease. Survivial rate not high. Mets to Liver.
- solid hypoechoic mass
- Elevated labe : Bilirubin, Alk phos. ,GGT, Amylase, Lipase
What is a Whipple Procedure?
Removal of head of pancreas, bile duct, GB, and duodenum is removed.
What is a pancreatic serous cystadenoma?
- benign
- associated with von Hippel-Lindau disease
- grape like cysts
What is a Mucinous Cystic Neoplasm?
- malignant or potential malignancy
- Increased CEA levels ( carcinoembryonic Antigen)
What s the most common Islet sell tumor?
Insulinoma
What is a Gastrinoma?
- Zollinger-Ellison Syndrome
- Second most common tumor
- Frequently malignant
What is a common location for islet cell tumors?
body and tail of pancreas
What is Multiple Endocrine Neoplasia?
- Inherited endocrine disorder
- MEN type 1: Wermer Syndrome
- MEN type 2: Sipple’s Syndrome
What are the most common involvements of MEN?
- Parathyroids
- Pancreatic islet cells
- Pituitary glands
- adrenal glands
- thyroid
Summary of chapter of relationships and labs…
Page 76 ESP
