Pathology of the Pancreas Flashcards
What is found in normal bile?
Bilirubin, Bile salts (hydrophilic) and cholesterol (hydrophobic).
How do gallstones form?
They form when there is an imbalance between the ratio of cholesterol to bile salts.
Most gallstones are a mixture of cholesterol stones and pigment stones, it is rare for it to be pure of either.
What are the risk factors for gallstones?
Cholesterol excess in bile.
Being female, overweight.
What is acute choleceystitis?
It is inflammation of the gallbladder and it is usually associated with gallstones.
The gallstones are obstructing the outflow of bile, this then leads to infection of the gallbladder, this can lead to a rupture, empyema or peritonitis.
(There is also chronic cholecystitis which is also associated with gallstones but usually causes the gallbladder wall to become thickened but not distended).
What is the name of the carcinoma of the bile duct?
Cholangiocarcinoma, usually presents late.
How does acute pancreatitis come about?
Bile reflux, duct obstruction due to stone damage to sphincter of Oddi both cause pancreatic duct injury, the loss of the protective barrier allows autodigestion of pancreatic juices such as proteases (cause tissue destruction and haemorrhage) and lipases (intra and peripancreatic fat necrosis).
What are some of the complications of pancreatitis?
Death. Shock. Pseudocyst formation. Abscess formation. Hyperglycemia.
How does chronic pancreatitis come about?
May occur due to acute pancreatitis or because of alcohol, cholecelithiasis, cystic fibrosis.
The pancreatic tissue is replaced with scar tissue and there is destruction of the exocrine acini and islets.
How do adenocarcinomas of the pancreas spread?
Through direct spread to other organisms (duodenum, stomach, spleen).
Spread to local lymph nodes.
Haematogenous spread to the liver.
