Pancreatic Disease Flashcards
What are the two functions of the pancreas?
Exocrine = Enzyme production Endocrine = Hormone production
What is acute pancreatitis?
Acute inflammation of the pancreas
What is mild acute pancreatitis?
Associated with minimal organ dysfunction
What is severe acute pancreatitis?
Associated with organ failure and/or local complication
What are the causes of acute pancreatitis?
Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion bites/stings Hyperlipidaemia/hyperthermia/hypercalcaemia ERCP Drugs
What are the symptoms of acute pancreatitis?
Epigastric/diffuse abdominal pain +/- radiation to the back Nausea and vomiting Indigestion Abdominal tenderness Loss of appetite +/- weight loss Temperature Jaundice
What blood test is used for diagnosing acute pancreatitis?
Amylase (decreases)
What imaging can be used to investigate acute pancreatitis?
Ultrasound = rules out biliary pancreatitis CT = assesses severity and complications
What is the treatment for acute biliary pancreatitis?
ERCP
What are the local complications of acute pancreatitis?
Fluid collection Pseudocysts Abscess Necrosis +/- infection Ascites Pleural effusion
What are the systemic complications of acute pancreatitis?
Pulmonary failure Renal failure Shock Sepsis Metabolic acidosis Hyperglycaemia Hypoglycaemia MODS
What is the treatment for pseudocysts?
Surgical drainage
Cystgastronomy = drain to stomach
Cystjejunostomy = drain to small bowel
What is the treatment for pancreatic abscess?
CT/US guided drainage
What is chronic pancreatitis?
Progressive and irreversible destruction of pancreatic tissue resulting in permanent loss of endocrine and exocrine function
What is the most common cause of chronic pancreatitis?
Alcohol abuse
What is the treatment for chronic pancreatitis?
Very complex
What type of cancer are the majority of exocrine pancreatic cancers?
Adenocarcinoma
What types of endocrine pancreatic cancers are there?
Gastrinoma
Insulinoma
Glucagonoma
What are the symptoms of pancreatic cancer?
Painless jaundice Dark urine, pale stools Weight loss Anorexia Nausea and vomiting Poss back pain
What are the risk factors for pancreatic cancer?
Age Smoking Charred meat Obesity and inactivity Diabetes Type I and II
What imaging can be used to investigate pancreatic cancer?
CT
Endoscopic ultrasound
ERCP (in this case, take brushings to type cancer)
What are the palliative treatments for pancreatic cancer?
Stenting
Radiotherapy
Chemotherapy
How are pancreatic cancers staged?
Tis to T4 = Size
N0 or N1 = Lymph nodes
M0 or M1 = Metastases
What is the curative treatment for pancreatic cancer?
Surgery
