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20 Cards in this Set

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Pancreas Divisum
Cause by lack of fusion between the dorsal and ventral pancreatic buds
10% population
Pancreas Divisum
Dorsal drainage is through the:
Ventral drainage is through the:
Minor papilla
Major papilla
Increased prominence of the pancreas head is an indication of:
Pancreas divisum
Von Hipple-Lindau Syndrome
Hereditary cancer
Related to hemangioblasts, sac tumors, pheochromocytomas, adenomas
72% had pancreatic cysts
Acute Pancreatitis pitfalls in US
Most diagnosis made with symptoms/lab results
US may be negative in mild forms
Acute Pancreatitis MILD
Edema limited to the gland, slight inflammation, necrosis of intra dn peripancreatic tissue
Acute Pancreatitis SEVERE
Necrosis of fat, parenchymas, and blood cells
Pseudocysts may form from severe inflammation
Acute Pancreatitis CAUSES
biliary tract disease
alchohol abuse
peptic ulcer
trauma, pregnancy, drugs
Acute Pancreatitis DEFINITION
Pseudocyst formations occur as the bodies attempt to wall off the pancreatic secretions to prevent digestion of the peripancreatic tissue
HIGH amylase, severe pain
Focal Pancreatitis sonographically
Focal hypoechoic lesion in the pancreas head
Usually alcholics, hx of pancreatitis or pain
Normal amylase could mean its a neoplasm
Diffuse Pancreatitis sonographically
Pancreas is hypoechogenic
Usually alcoholics w/ assoc. fatty infiltration
Acute Pancreatitis
ASSOC. FINDINGS
fluid collections, edema
Extrapancreatic fluid, clear or septated pancreatic fluid
Pseudocyst DEFINITION
Fluid collection that develops into a well-defined smooth walled structure with acoustic enhancement and persists for over 4 weeks.
Pseudocyst ASSOCIATIONS
10-20% pancreatitis pts
alcholism, biliary etiology, trauma, increased amylase
Pseudocysts
30-40% pts have complications including:
GI bleed
Obstructed stomach, small bowel, colon, bile ducts
Acute peritonitis (after the cyst breaks)
Pseudocyst DECOMPRESSION
Over 6 weeks, larger than 5 cm, smaller symtpomatic pseudocysts, presence of infection, hemorrhage, or perforation
Acute Pancreatitis ABSCESS
dx: gram negative enteric bacteria lab values
100% death risk if untreated
More common post-op
Look like thick walled pseudocysts with gas bubbles and debris
Acute Pancreatitis VASCULAR COMPLICATIONS
Venous or arterial thrombosis
Pseudoaneurysm formation
Aneurysms
Acute Pancreatitis ASCITES
Anterior slow leak in pancreatic fluid into peritoneal cavity from the pancreatic duct or pseudocyst
Acute Pancreatitis PLEURAL EFFUSION
Posterior leak that moves cephalad to the mediastinum and pleural space, resulting in PE usually on L side