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Abdominal Pathologies > pancreas pathology > Flashcards

pancreas pathology Flashcards

1
Q

what portion of the pancreas is usually present in partial pancreatic agenesis?

A

the head and uncinate process

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2
Q

what is pancreatic divisum?

A

pacreatic divisum is the congenital lack of fusion with the pancreatic ducts

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3
Q

what are the potential complications of pancreatic divisum?

A

it can cause pancreatitis

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4
Q

were does ectopic pancreatic tissue usually develop?

A

within the GI tract

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5
Q

is ectopic pancreatic tissue functioning?

A

yes

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6
Q

what is an annular pancreas?

A

annular pancreas is where the head of the pancreas surrounds the second portion of the duodenum.

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7
Q

how do congenital cysts usually appear?

A

cysts result of the abnormal development of the pancreatic ducts

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8
Q

pancreatic congenital cysts can be associated with….

A

Von Hippel-Lindau syndrome and ADPKD

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9
Q

what is the most common genetic disease in white children?

A

cystic fibrosis

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10
Q

how does cystic fibrosis affect the pancreas?

A

cystic fibrosis causes a blockage in the pancreatic ducts, results in the delivery of pancreatic enzymes and poor digestion of food.

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11
Q

what are the clinical symptoms of cystic fibrosis when it starts to affect the pancreas?

A
  • N/V
  • poor digestion
  • malnutrition
  • weight loss
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12
Q

how would the pancreas appear in a cystic fibrosis patient?

A

hyperechoic, atrophied, calcifications, and small cysts

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13
Q

what are the 5 Bs of acute pancreatitis?

A

1) Booze
2) blood- trauma
3) Bile- Biliary
4) Bug- infection
5) Birth- congenital

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14
Q

what is the most common cause of acute pancreatitis?

A

biliary disease

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15
Q

what is the second most common cause of acute pancreatitis?

A

alcohol abuse

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16
Q

what are the clinical signs of acute pancreatitis?

A

severe abd pain in the epigastric region, often radiating to the back. usually occurs after a large meal or alcohol binge, fever, nausea, and less commonly vomiting

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17
Q

what lab values diagnose acute pancreatitis?

A
  • amylase will increase, will remain for 24 hours
  • Lipase will increase, will remain elevated for 5 to 14 days
  • leukocytosis
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18
Q

what is the sonographic appearance for acute pancreatitis?

A
  • diffuse enlargement with loss of normal texture (irregular borders)
  • less echogenic than liver
  • pancreatic duct may be obstructed
  • gallstones are present in 60% of patients
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19
Q

what are the complications of acute pancreatitis?

A
  • Pseudocyst
  • Phlegmon
  • Abscess
  • Hemorrhage
  • Duodenal obstruction
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20
Q

what is the most common cause of children with pancreatitis?

A

trauma results from child abuse (battered child syndrome)

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21
Q

what is a pseudocyst?

A

fluid collection that arises from inflammatory process, necrosis, or hemorrhage (tissue destruction)

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22
Q

where is the most common location for a pseudocyst?

A

Most commonly located in the lesser sac, tail region, anterior pararenal space, more often in the left pararenal space

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23
Q

what is the sonographic appearance of a pseudocyst?

A
  • Usually single, but there can be multiple
  • Usually oval or round
  • Around 2-20cm
  • Sonolucent, echo-free mass, increased posterior enhancement
  • If fluid-debris is visualized, abscess or hemorrhage should be considered
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24
Q

why is a pseudocyst worrisome?

A

they can rupture and kill the surrounding tissue

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25
Q

what are the clinical signs of a ruptured pseudocyst?

A

sudden shock of peritonitis

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26
Q

what is phlegmonous pancreatitis?

A

severe form of acute pancreatitis caused by extension outside the gland

27
Q

how will it appear on ultrasound?

A
  • tissue appears hypoechoic with irregular borders
  • usually involves the lesser sac, pararenal space, and transverse mesocolon
28
Q

what is hemorrhagic pancreatitis?

A

necrosis of blood vessel walls causing hemorrhage. diffuse destruction causing necrosis in and around pancreas

29
Q

what is the most common cause of hemorrhagic pancreatitis?

A

alcoholic binges or very large meals

30
Q

what is the mortality rate of hemorrhagic pancreatitis?

A

60%

31
Q

what are the clinical signs of hemorrhagic pancreatitis?

A
  • Severe abdominal pain
  • n/v
  • abdominal distension due to ileus
  • hypotensive
  • shock
  • increase amylase and lipase
  • decreased hematocrit
32
Q

what is a pancreatic abscess?

A

collection of pus in or around the gland.

33
Q

how is a pancreatic abscess developed?

A

they are developed due to the superinfection of the necrotic pancreas.

34
Q

what is a pancreatic abscess associated with?

A

postoperative pancreatitis

35
Q

how does a pancreatic abscess appear on US?

A

hypoechoic mass that may have internal echoes

36
Q

define chronic pancreatitis

A

recurrent attacks of acute pancreatitis. it results in irreversible damage to the gland due to progressive destruction

37
Q

what is the most common cause of chronic pancreatitis?

A

alcoholism and is more common in males

38
Q

clinical signs of chronic pancreatitis

A
  • Persistent epigastric pain and back pain radiating to the back
  • n/v
  • weight loss
  • diabetes in later stages
  • jaundice
39
Q

lab values of chronic pancreatitis

A
  • Amylase/lipase tests are not good indicators
  • Fat in feces
  • Abnormal glucose-tolerance test
40
Q

sonographic appearance of chronic pancreatitis

A
  • Heterogenous with increased echogenicity due to fibrotic changes, fatty changes, and calcification
  • Ductal dilation
  • Irregular outline to the gland
  • Varied: small and atrophied
  • Calculi within ducts and cyst formations
41
Q

complications of chronic pancreatitis

A
  • Pseudocysts
  • Thrombosis of the splenic vein and/or portal vein
  • Biliary stricture
  • Carcinoma
42
Q

what is the most common pancreatic cancer?

A

adenocarcinoma

43
Q

what are the risk factors for adenocarcinoma?

A
  • smoking
  • high-fat diet
  • chronic pancreatitis
  • diabetes
  • cirrhosis
44
Q

what are the clinical signs for adenocarcinoma?

A
  • More common in males older than 60
  • Symptoms occur late, 90% will have mets before the cancer is diagnosed
  • Pain radiating to the back
  • Steady aching epigastric pain
  • Weight loss
  • Painless jaundice, usually presence first
  • n/v
  • new onset of diabetes
45
Q

where does adenocarcinoma usually occur?

A

in the head of the pancreas

46
Q

define courvoisier’s sign

A

indicates jaundice in the gallbladder that is enlarged but not painful

47
Q

where does metastases usually occur?

A

liver, portal system, or nodes

48
Q

what is a cystadenoma

A

rare, benign tumors in the pancreas

49
Q

where do cystadenomas usually occur?

A

more common in the head of the pancreas and can contain calcifications

50
Q

what is the sonographic appearance of a cystadenoma?

A

anechoic mass or echogenic mass with hyper and hypoechoic areas

51
Q

where do cystadenocarcinomas usually appear?

A

in the tail of the pancreas

52
Q

how do cyst adenocarcinomas appear on ultrasound?

A
  • large, unilocated complex mass
  • cysts may contain calcifications
  • 60% occur in the tail of the pancreas
53
Q

clinical signs of a cystadenocarcinoma

A

epigastric pain and a palpable mass

54
Q

what is an islet cell tumor?

A

an Islet cell tumor is a rare type of hormone-producing tumor that forms in the tissue of the pancreas.

55
Q

what are the two types of islet cell tumors?

A

insulinoma and gastrinoma

56
Q

is insulinoma benign or malignant?

A

Benign

57
Q

is gastrinoma benign or malignant?

A

benign, but 60% become malignant

58
Q

what is the most common islet cell tumor?

A

insulinoma (70%)

59
Q

what type of cells are insulinomas?

A

B-cell

60
Q

what type of cell produces insulin?

A

B-cell or Beta Cell

61
Q

what are the clinical signs of an insulinoma?

A

hypoglycemia and elevated insulin levels

62
Q

what is the second most common islet cell tumor?

A

gastrinoma (20%)

63
Q

where are islet cell tumors usually located?

A

in the body and tail of the pancreas

64
Q

how do islet cell tumors appear on an ultrasound?

A
  • difficult to image due to their small size
  • 1-2cm
  • located in the body or tail of the pancreas
  • small, well-defined, homogenous, solid, hypoechoic mass
  • well-encapsulated with good vascular supply

Abdominal Pathologies (8 decks)

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