Pancreatitis 1 Flashcards
The pancreas is mostly composed of endocrine or exocrine function?
exocrine function (mostly acinar cells)
What is pancreas divisum?
Failure of fusion of the fetal duct systems of the dorsal and ventral
pancreatic primordia
Main pancreatic duct (Wirsung) is short
Bulk of the pancreas (formed by the dorsal pancreatic primordium) drains through minor sphincter
Most common significant congenital anomaly of the pancreas is what?
pancreas divisum
What complication does pancreas divisum predispose a patient to?
chronic pancreatitis
What gene is affected in agenesis of the pancreas?
IPF1 gene mutations on chromosome 13q12.1
or caused by homozygous germline mutations in PDX1, a gene encoding a homeobox transcription factor critical for pancreatic development
What is agenesis of the pancreas?
Partial agenesis of the pancreas is characterized by the congenital absence of a critical mass of pancreatic tissue
What is annular pancreas?
and like ring of normal pancreatic tissue encircles the second portion of the duodenum, can cause duodenal obstruction
What is ectopic pancreas?
in 2% of the population; pancreas in different sites of the GI.
What are the favorite sites for ectopic pancreas?
favored sites: stomach, duodenum, jejunum, Meckel diverticulum, and ileum
What are congenital cysts?
part of polycystic disease (also in kidney and liver)
Is acute pancreatitis reversible?
yes; organ can return to normal if underlying cause of inflammation is removed
Is chronic pancreatitis irreversible or reversible?
irreversible destruction of the exocrine pancreatic parenchyma due to scarring
What is the cause of 80% of the cases of acute pancreatitis?
biliary tract disease or alcoholism
What is the most common cause of pancreatitis in children?
seat belt trauma
Why is pancreatic pain often referred to the back?
because of the retroperitoneal location of the pancreas
What are some DD’s of acute pancreatitis?
ruptured acute appendicitis, perforated peptic ulcer, acute cholecystitis with rupture, occlusion of mesenteric vessels with infarction of bowel
What are some major complications associated with acute pancreatitis?
DIC, ARDS, peripheral vascular collapse (shock), hypoxemia (because circulating pancreatic phospholipase destroys surfactant), shock, hypocalcemia tetany (because calcium binds to fatty acids decreasing the ionized calcium).
How can acute pancreatitis cause third spacing and concurrently pulmonary edema?
- In acute pancreatitis – the pancreas autodigests itself, causing peripancreatic collection of fluid leading to
Hypovolemic shock - If conditions improve, the third space fluid gains entry back into the vascular compartment and may cause
Fluid Overload