Pancreas, Spleen Flashcards
most common pancreatic endocrine neoplasm;
INSULINOMA
Pancreatic tumor related to MEN1
INSULINOMA
GASTRINOMA
tumor
CT, EUS, MRI: 70-90% found in Passaro’s triangle (head of pancreas medially, 2nd portion of
duodenum inferiorly, and the confuence of the cystic and CBD superiorly)
GASTRINOMA
cause of Zollinger-Ellison syndrome,
GASTRINOMA
Tumor
commonly located in the distal pancreas and most are malignant when
diagnosed
VASOACTIVE INTESTINAL PEPTIDE-SECRETING TUMOUR
Most common cause of Pancreatitis
GALLSTONE
what is Inglefnger’s sign in pancreatitis
pain worse when supine, and better when sitting forward
Pancreatitis
most sensitive and specific investigation
- lipase
Cause of pancreatitis if Amlayse > lipase
alcohol
Gallstone pancreatitis surgical management
cholecystectomy during same admission (25-60% recurrence if no surgery)
Gallstone Pancreatitis
Mngt if with CBD stone or cholangitis
t ERCP + sphincterotomy
Necrotizing Pancreatitis
Mngt refractory to medical management
drain placement and debridement
Absolute contraindication for drainage of pancreatic pseudocyst
pseudoaneurysm
Pseudocyt wall maturation prior to drainage
(4-6 wk)
Pancreatic CA most common symptom
abdominal pain, jaundice, and weight loss
Pancreatic CA
most common location
head of the pancreas (70%)
Pacreatic CA
surgical procedure for cure
Whipple procedure (pancreaticoduodenectomy)
Pancreatic CA
surgical procedure
- if carcinoma of midbody and tail of
pancreas
distal pancreatectomy ± splenectomy, lymphadenectomy
Indication of Splenectomy
SHIRTS
Splenic abscess/splenomegaly
Hereditary spherocytosis
Immune thrombocytopenic purpura
Rupture of spleen
Thrombotic thrombocytopenic purpura
Splenic vein thrombosis
Most common indication for spleenectomy
trauma
Vaccination post / pre splenectomy
vaccinations, ideally 2 wk pre- or postoperative (pneumococcal, H. infuenzae, and meningococcus)
* liberal use of penicillin especially in children <6 yr
Splenic Infarct
indication for spleenectomy
rupture, abscess, persistent pseudocyst, bleeding,
or sepsis
