Week 3.8 - Pancreatic Disease Flashcards
What is chronic pancreatitis?
rare continuous inflammatory disease showing irreversable glandular damage of pancreatic ducts, effecting endocrie and exocrine functions and causing significant pain
What are causes of chronic pancreatitis?
- 80% alcohol,
- also smoking,
- cystic fibrosis,
- congenital
- genetic
What are common symptoms of chronic pancreatitis?
90% pain, exocrine sufficiency symptoms, endocrine insufficiency symptoms
What are endocrine and exocrine insufficiency symptoms seen in chronic pancreatitis?
endo - diabetes
exo - low BMI, vitamin deficiency, osteoporosis
How do you investigate chronic pancreatitis?
MRI and EUS most specific for this. CT too
How do you approach chronic pancreatitis?
needs MDT -
- alcohol,
- smoking,
- nutrition
- metabolic issues,
- psychological aspect,
- diabetes
How do you manage chronic pancreatitis?
stent endoscopically if there is stricture or stones. if not possible surgical intervention necassary.
What are pancreatic cyst lesions?
cysts in pancreas - can be neoplastic, non neoplastic, endothelial or non endothelial
What category are IMPN and MCN cysts? what does this mean?
epithelial neoplastic. require surgery.
What cyst is non-epithelial non-neoplastic? what does this mean?
pseudocyst following acute pancreatitis. filled with fluid. can be left alone, may need just drainage.
When would you refer a PCL?
if it has high risk features or if they have worrying features
What are high risk and worrying features regarding PCL’s?
high risk
- jaundice
- over 10cm dilated
- enhancing nodule
worrisome
- pancreatitis
- thick cyst wall
- significant cyst growth
How do we assess PCL’s?
- MRI accurate.
- EUS for FNA samples and fluids to determine if mucinous or not, benign or malignant, biochem etx.
- also use contrast for nodes/abnormalities
What do patients with pancreatic carcinoma present with symptomatically?
all exocrine malfunction results -
- weight loss,
- poor appetite,
- steatorrhoea,
- vomiting,
- nausea,
- fatigue
What signs do we see in pancreatic cancer patients depending on site of tumour?
- upper abdominal pain if in head or tail
- painless obstructive jaundice in head of pancreas
