Pancreas Flashcards
define pancreatitis
inflammation of the pancreas due to excess bile either due to obstruction or hyper stimulation of acinar cells which causes release of proteases and lipases that destroy tissues
causes of pancreatitis
I GET SMASHED idiopathic gallstones ethanol (alcohol) trauma scorpion bite mumps autoimmune steroids hypercalcaemia/hyperlipidaemia ERCP drugs e.g. azathioprine
presentation of pancreatitis
acute onset epigastric pain that radiates to the back (relieved by sitting forward) nausea and vomiting jaundice cullen's sign Grey-Turner's sign
diagnosis of pancreatitis
elevated serum amylase
high glucose in chronic
LFTs
CT
management of pancreatitis
- cholecystectomy
- ERCP if gallstones
- glasgow and ranson criteria
- CREON and ADEK for chronic
- Pustow procedure (anastomosis of pancreatic duct and duodenum)
Frey procedure (pancreas head removed) - nasojejunal feeding avoids pancreatic secretions
what is pancreatic carcinoma associated with?
charred meat, smoking, diabetes and pancreatitis
what can a pancreatic carcinoma cause
duodenal obstruction
classification of pancreatic carcinomas
adenocarcinomas
gastrinomas
insulinomas
glucagonomas
presentation of pancreatic carcinoma
- jaundice (light stools and dark urine)
- weight loss
- back pain
diagnosis of pancreatic carcinoma
US, CT
LFTs
MRCP
ERCP
management of pancreatic carcinoma
surgical resection (+ CREON, biliary stenting)
chemotherapy/radiotherapy
Whipple’s procedure (pancreaticoduodenectomy)
examples of rare hormone-secreting pancreatic tumours
- insulinoma
- glucoagonoma
- VIPoma (vasoactive intestinal peptide-oma)
- gastrinoma
presentation of insulinoma
recurrent hypoglycaemic attacks
presentation of glucagonoma
diabetes
dermatitis
presentation of VIPoma
watery diarrhoea
