Pancreatic Disease: Medical and Endoscopic Management Flashcards
Regarding the Atlanta classification for pancreatic fluid, a common complication of pancreatitis, what can interstitial edematous pancreatitis fluid be known as <4 weeks?
Acute peripancreatic fluid collection
Regarding the Atlanta classification for pancreatic fluid, a common complication of pancreatitis, what can interstitial edematous pancreatitis fluid be known as >4 weeks?
Pseudocyst
Regarding the Atlanta classification for pancreatic fluid, a common complication of pancreatitis, what can necrotizing pancreatitis fluid be known as <4 weeks?
Acute necrotic collection
Regarding the Atlanta classification for pancreatic fluid, a common complication of pancreatitis, what can necrotizing pancreatitis fluid be known as >4 weeks?
Walled off necrosis
Which complication of pancreatitis can lead to pleural effusion?
Pancreatico-pleural fistula
What would be shown in the sampling of the pleural fluid to suggest the fluid had been in contact with the pancreas?
Very high amylase
What is the medical management of pancreatico-pleural fistula?
Pleural effusion aspiration
Advise smoking and alcohol cessation
Consider Octreotide injections
What would draining the pleural effusion help to reduce?
The patient’s SOB
What is the medical management for someone with pancreatic ascites?
NJ tube feeding, Octreotide injection and draining of the ascites.
If pancreatic ascites reoccurs, what can be done?
ERCP to insert a pancreatic duct stent
RECAP- what is chronic pancreatitis?
Continuing inflammatory disease of the pancreas which impairs endocrine and exocrine function.
What causes chronic pancreatitis?
Alcohol
Cystic fibrosis
Congenital anatomical abnormalities
Genetics
Hypercalcaemia
Autoimmune diseases- coeliac disease, important to rule out
What is the main cause of chronic pancreatitis?
Alcohol
What are some of the clinical features of chronic pancreatitis?
Abdominal pain, exocrine and endocrine insufficiency
What may exocrine insufficiency manifest as?
Low BMI
Vitamin Deficiency
Osteoporosis
What may endocrine insufficiency manifest as?
Diabetes
Which investigations are the most sensitive when looking for chronic pancreatitis?
MRI
Endoscopic ultrasound
Name some contributing factors to chronic pancreatitis which can be sorted via endoscopy.
Pancreatic duct stones
Pancreatic duct stricture
What are some of the worrying features of a pancreatic cyst?
> 10mm
Jaundice
Have an enhancing nodule
What is the preferred form of radiology for the imaging of pancreatic cystic lesions?
MRI, most accurate
What are some of the clinical features of pancreatic cancer?
Abdominal pain
Painless obstructive jaundice
Weight loss
Anorexia/fatigue/vomiting/diahorrea or steatorrhea
What is the most common symptom for cancer of the pancreatic tail?
Abdominal pain
Where would the cancer tend to affect the pancreas for painless obstructive jaundice to be observed?
Pancreatic head
Which treatment options can be considered for head of the pancreas cancer?
Radio Frequency Ablation
What is one of the most effective forms of pain management in those with pancreatic cancer?
Coeliac plexus block
How can coeliac plexus block be carried out?
Guided by endoscopic ultrasound
