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CNIH > Peds- Pancreas > Flashcards

Peds- Pancreas Flashcards

1
Q

what to use as a window for pancreas seen on children and infants?

A
  • larger left lobe liver
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2
Q

U/S features pancreas?

A
  • homogrneous
  • hypoechoic
  • splenic v. inferior and posterioe to the pan. tail
  • SMV- posterior to junction of the head and body
  • IVC- posterior and slightly to the right of the head
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3
Q

Pancreatic duct measurement?

A
  • <1mm
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4
Q

congenital anomalies of the pancreas? (2)

A
  1. cyctic fibrosis

2. congenital cysts

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5
Q

Cystic Fibrosis

A
  • Autosomal recessive
  • High prevalence in Caucasians
  • Mostly affects lungs, but also panc., liver, kidneys, intestine
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6
Q

cystic fibrosis causes?

A
  • Exocrine glands produce highly viscous mucus
  • Small ductules of panc get obstructed
  • Tissue destruction, atrophy, replacement with fibrosis and fat
  • Pancreatic insufficiency →improper digestion, steatorrhea
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7
Q

cystic fibrosis sono?

A
  • hyperechoic and small panc.
  • Small cysts and Ca2+ may be present
  • Liver disease and gallstones
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8
Q

Pancreatic Neoplasms? (3)

A
  • Rare in children
  • Manifestations are similar to those in adults
  1. Pancreatic Carcinoma
  2. Islet Cell Tumors (Insulinoma)
  3. Lymphoma (mets)
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9
Q

Pancreatic Carcinoma?

A
  • Non-functioning tumor

- Rare in children

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10
Q

Pancreatic Carcinoma clinical presentation?

A

Non-specific signs and symptoms

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11
Q

Pancreatic Carcinoma sono features?

A
  • Large at presentation
  • Hypoechoic mass
  • Mets to the liver, lymph nodes, and lungs typically has occurred
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12
Q

Islet Cell Tumors?

A
  • 2/3 of these produce hormones
  • clinical suspicion early in the course of disease
  • 1/3 does not
  • grow large and obstructs the biliary system or GI tract
  • Diagnosed via blood work
  • Ultrasound is used in localizing the tumor, especially intraoperative
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13
Q

sono features of islet cell tumors?

A
  • Well circumscribed
  • Anechoic
  • Mets might be present
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14
Q

Insulinoma (functioning islet cell tumor) location?

A

Mostly located in the body or tail of the pancreas

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15
Q

Insulinoma (functioning islet cell tumor) Clinical Presentation?

A
  • Hypoglycemia
  • Erratic behavior
  • Seizures
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16
Q

Insulinoma (functioning islet cell tumor) sono features?

A
  • Small, round
  • Hypoechoic
  • Well-circumscribed mass
17
Q

2 types of Pancreatitis?

A
  • Acute pancreatitis
  • Complications
  • Chronic pancreatitis
18
Q

acute pancreatitis causes? (5)

A
  1. Blunt abdo trauma
  2. Infections, usually viral
  3. Drug toxicity
  4. Hereditary
  5. Idiopathic
19
Q

Acute pancreatitis- pathogenesis?

A

pancreatic enzymes escape into surrounding tissue

20
Q

acute pancreatitis diagnosis?

A
  • Clinical and Lab data

- Imaging is helpful

21
Q

acute pancreatitits clinical presentation?

A
  • Nausea & Vomiting
  • Abdo pain
  • Fever, tachycardia, abdo distention
22
Q

actute pancreatitis sono features?

A
  • Enlarged pancreas
  • Edematous
  • Less echogenic than liver
  • Normal – similar to more echogenic than liver
  • Dilated pancreatic duct
  • d = 1.5 mm or more
  • normal – less than 1 mm
23
Q

acute pancreatitis complications (4)?

A
  1. Pseudosysts
  2. hemorrhage
  3. phlegomon
  4. abscess
24
Q

pseudocyst locations?

A
  • mostly around pancreas can be anywhere in abdomen and pelvis
25
Q

pseudocyst symptoms?

A
  • abdo pain
  • bowel/biliary system obstruction
  • nausea and vomiting
26
Q

pseudocyst lab data?

A

elevated serum amylase

27
Q

pseodocyst sono apperance?

A
  • anaechois
  • sharp walls
  • single or multiple
  • simple or complex
28
Q

Hemorrhage?

A
  • Disruption of panc vessels
  • Can be lethal
  • May produce large panc hematoma
29
Q

hemorrhage sono?

A

Inhomogenous mass

From anechoic to echogenic

30
Q

Phlegmon?

A
  • Solid inflammatory mass
  • Consists of necrotic tissue, inflammatory exudate and tissue edema
  • Can develop into abscess
31
Q

phlegmon sono?

A

anachoic mass

32
Q

Abscess causes?

A
  • Severe cases of pancreatitis with extensive necrosis

- Infected Phlegmon or Pseudocyst

33
Q

abscess symptoms?

A
  • spiking fevers
  • chills
  • abdo pain
34
Q

abscess sono feature?

A
  • Large anechoic mass in panc bed
  • Debris / purulent material
  • Thick, irregular, echogenic walls
  • If air present (gas forming bacteria) – shadowing
35
Q

abscess treatment?

A
  • percutaneous drainage
36
Q

Chronic pancreatitis?

A
  • A clinical condition caused by multiple bouts of acute pancreatitis
  • Causes fibrosis and destruction of pancreatic cells
  • Pancreatic fibrosis causes areas of strictures and dilation of the main pancreatic duct

CNIH (69 decks)

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