pancreatitis Flashcards
ALS
What are the functions of the pancreas?
The pancreas has both endocrine functions (producing insulin and glucagon) and exocrine functions (producing enzymes like amylase, lipase, and trypsin).
Define acute pancreatitis.
Acute pancreatitis is the acute inflammation of the pancreas, which is reversible.
What are the diagnostic criteria for acute pancreatitis?
Diagnosis requires at least 2 out of 3 criteria: Upper abdominal pain, serum amylase or lipase levels >3 times the upper limit of normal, and typical imaging findings.
List the causes of acute pancreatitis.
Causes include obstruction (e.g., gallstones, cystic fibrosis), metabolic factors/drugs (e.g., alcohol, hyperlipidemia), trauma, infections, ischemia, and genetic factors.
Explain the pathogenesis of acute pancreatitis.
Pathogenesis involves pancreatic duct obstruction, primary acinar injury, and defective intracellular transport of trypsinogen. Alcohol acts by causing pancreatic duct obstruction and increasing pancreatic enzyme secretion.
-obstruction can cause back up of pancrease contents, and the pressure will compress pancreatic blood pressure, resulting in ischemia
-the pressure also will activate inactive proteases (zymogens) , which will digest pancreatic tissue (necrosis)
Describe the morphological changes seen in severe acute pancreatitis.
Severe acute pancreatitis can lead to systemic dissemination of digestive enzymes and inflammatory cytokines, resulting in complications such as disseminated intravascular coagulopathy, respiratory distress syndrome, and multiple organ failure.
What are the complications of acute pancreatitis?
Complications include systemic complications like disseminated intravascular coagulopathy, respiratory distress syndrome, and hypovolemia leading to shock and multi-organ failure.
What investigations are used to diagnose acute pancreatitis?
Diagnosis is based on biochemical tests showing elevated serum amylase and lipase levels, along with imaging studies like ultrasound, MRI, or CT scan revealing features such as an enlarged pancreas, gallstones, or necrosis/haemorrhage.
Define chronic pancreatitis.
Chronic pancreatitis is the chronic inflammation of the pancreas leading to irreversible damage of the exocrine pancreas, eventually causing endocrine cell destruction.
What are the causes of chronic pancreatitis?
Causes include toxicity/oxidative stress (e.g., alcohol), obstruction (e.g., gallstones, cystic fibrosis), and special types such as tropical pancreatitis, hereditary pancreatitis, cystic fibrosis, and autoimmune pancreatitis.
Explain the pathogenesis of chronic pancreatitis.
Chronic inflammation leads to proliferation of fibroblasts, collagen deposition, fibrosis, and acinar atrophy, initially sparing islet cells.
List the complications of chronic pancreatitis.
Complications include malabsorption (especially fat-soluble vitamins), diabetes mellitus, and pancreatic carcinoma.
