Pancreatic Disorders Flashcards
What is the pathology of Pancreatic cancer?
Ductal adenocarcinoma
60% head
25% body
15% tail
What types of pancreatic cancer have better prognosis?
Ampullary tumours
Tumours of pancreatic islet cells
What is the genetics of pancreatic cancer?
95% have mutations in the KRAS2 gene
What are the risk factors for pancreatic cancer?
Smoking
Alcohol
Carcinogens
DM
Chronic pancreatitis
Inherited predisposition
What is the common presentation of pancreatic cancer?
Painless obstructive Jaundice
Epigastric pain
Palpable gall bladder
Anorexia
Weight loss
Vomiting
Hepatomegaly
Splenomegaly
Lymphadenopathy
Ascites
What investigations are done for pancreatic cancer?
Bloods
Tumour markers
US
CT
ERCP/MRCP
EUS
What is the staging algorithm for potentially resectable pancreatic cancer?
USS -> ERCP+Stent -> Spiral CT/MRI -> Laparscopy -> Lapartomy -> Resection
What is the treatment options for pancreatic cancer?
Surgery: Resection (Pancreatoduodenectomy; Whipple)
Laparoscopic excision
Post op chemo
Palliation of jaundice: stent insertion
Palliative bypass for duodenal obstruction
What is the prognosis of pancreatic cancer?
Mean survival <6 months
5 year survival 3%
What are the 2 main causes of acute pancreatitis?
Gallstones
Alcohol
How does alcohol cause acute pancreatitis?
Direct injury
Or increased sensitivity to stimulation
How do gallstones cause acute pancreatitis?
Raised pancreatic ductal pressure
What are the symptoms of acute pancreatitis?
- Abdominal pain
- Nausea, vomiting
- Collapse
What are the signs of acute pancreatitis?
- Pyrexia
- Dehydration
- Abdominal tenderness
- Circulatory failure
What are the local complications of acute pancreatitis?
- Acute fluid collection
- Pseudocyst
- Pancreatic abscess
- Pancreatic necrosis
