Pancreatic Disease Flashcards
Describe Pancreas Divisum.
Most of the pancreatic contents drain through a minor papillary vessel instead of through the sphincter of Oddi
What are the three main congenital pancreatic issues, excluding Pancreas Divisum?
Annular pancreas, ectopic pancreas, agenesis
What are the three physiological factors that prevent pancreatic autodigestion?
Packaging in vesicles (zymogens), inactivated trypsin, and trypsin inhibitors
What is the main cause of pancreatitis?
Inappropriate release and activation of enzymes causing autodigestion.
Which three pathological factors that cause pancreatitis?
Duct obstruction, primary acinar cell injury, defective intracellular transport
Describe the main symptoms of acute pancreatitis.
Crippling back pain, anorexia, nausea, vomiting
Describe the clinical signs and markers that indicate acute pancreatitis.
Clinical signs - erythema abigne, Cullen’s sign, Grey Turner’s sign
Markers - amylase and lipase raised
What are the life-threatening complications of pancreatitis?
Hypovolaemic shock, pulmonary and renal failure, acute respiratory distress syndrome (ARDS)
What are the principles of management of pancreatitis?
IV fluids/analgesia, nil by mouth (‘resting’ the pancreas), and O2/abx may be required
What are the prognostic features of acute pancreatitis?
PANCREAS - PaO2, Age, Neutrophils, Calcium, Renal function, Enzymes, Albumin, Sugar
Name the two types of pancreatic cyst and how they are treated.
Congenital - nothing unless severe
Pseudocysts - drainage
Name the four types of exocrine pancreas neoplasm.
Serous, mucinous, intraductal papillary mucinous, solid pseudopapillary
Name the four main pancreas cells and neoplasms.
a cells - glucagon (glucagonoma)
B cells - insulin (insulinoma)
Delta cells - somatostatin (gastrinoma)
F cells - pancreatic polypeptide
Name the resectable and non-resectable procedures for endocrine neoplasms.
Resectable - Whipple’s, pancreatectomy
Non-resectable - palliative bypass
Why is the prognosis of pancreatic cancer so low?
Usually asymptomatic until grown and invaded due to growth in tail
