pancreatic disease Flashcards
presentation of pancreatic disease
obstructive jaundice
diabetes abdominal pain anorexia vomiting weight loss recurrent bouts pancreatitis
pancreatic disease investigation
blood tests
CXR
CT scan
laparoscopy
peritoneal cytology
percutaneous needle biopsy
palliative drainage of obstructive jaundice
palliative bypass vs ERCP
palliative drainage of duodenal obstruction
palliative bypass vs duodenal stent
what is acute pancreatitis?
an acute inflammatory process of the pancreas characterized by irreversible morphological changes leading to chronic pain and / or impairment of endocrine and exocrine function of the pancreas.
Mild AP
associated with minimal organ dysfunction and uneventful recovery
severe AP
associated with organ failure or local complication
local complications of AP
acute fluid collections
pseudocyst
pancreatic abscess
pancreatic necrosis
AP aetiology
gall stones
alochol
viral infections (mumps)
tumours
anatomical abnormalities
ERCP
hypercalcemia
drugs
ERCP (endoscopic retrograde cholangiopancreatography)
is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube
AP can be monitored in stages by the ….. criteria
glasgow criteria
CT scanning in AP can be useful in detecting complications such as
acute fluid collections
abscess
necrosis
monitoring progress of disease
Management of necrosis in AP
laparotomy
necrosectomy
causes of Chronic pancreatitis
obstruction of MPD
tumour (adenocarcinoma)
sphincter off oddi dysfunction
pancreatic divisum
duodenal onstruction
trauma
structure
causes of Chronic pancreatitis
genetic
CFTR
PRSS1
Chronic pancreatitis clinical features
pain
pancreatic exocrine insufficiency
diabetes
jaundice
duodenal onstruction
upper GI haemorrhage
CP investigations
CT scan
ERCP
faecal/serum enzymes
diagnostic enzymes replacement
CP investigations
CT scan
ERCP
faecal/serum enzymes
diagnostic enzymes replacement
CP management
counselling
no alcohol
analgesia
low fat diet
CP surgery complications
pancreatic duct stenosis
cyst
biliary tract obstruction
splenic vein thrombosis
portal vein compression
duodenal stenosis
colonic stricture
CP interventional procedures
stenosis (endoscopic sphincetortomy)
managing chronic pseudocyst
thoracoscopic
