Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
8 Cards in this Set
- Front
- Back
|
Annular pancreas |
Developmental malformation Form a ring around duodenum; risk of duodenal obstruction |
|
|
Acute pancreatitis |
Inflammation and hemorrhage of pancreas Autodigestion of panc parenchyma by enzymes
Premature activation of trypsin leads to activation of others Liquefactive hemorrhagic necrosis and fat necrosis
Features: Epigastric pain that radiates to the back N/V Periumbilical and flank hemorrhage ⬆️serum lipase (more specific) and amylase ⬇️Ca - saponification uses up Ca (poor prognosis, extensive necrosis) |
|
|
Complications of acute pancreatitis |
1. Shock 2. Pancreatic pseudocyst - fibrous tissue that surrounds liquefactive necrosis; wall it off
Present as abdominal mass with persistently elevated amylase May rupture and cause extensive hemorrhage in the abdominal cavity 3. Pancreatic abscess - due to E coli, abdominal pain, high fever, and ⬆️ amylase 4. DIC, ARDS |
|
|
Causes of acute pancreatitis |
Alcohol and gallstones - most common Trauma esp in children Hypercalcemia (activate enzymes) and hyperlipidemia Drugs Scorpion stings Mumps virus Rupture of posterior duodenal ulcer - head of pancreas lies behind it |
|
|
Chronic pancreatitis |
Fibrosis of pancreatic parenchyma, sec to recurrent acute panc Adults - alcohol Children - cystic fibrosis (thick mucus, slows drainage, ⬆️ risk for early activation of enzymes Many cases idiopathic
*amylase and lipase are not useful markers bec pancreas is vastly destroyed |
|
|
Chronic pancreatitis features |
Features: 1. Epigastric abdominal pain radiating to the back 2. Pancreatic insufficiency - malabsorption (steatorrhea, vit deficiency) 3. Dystrophic calcification of pancreas - calcification wrapping around pancreas; chain of lakes pattern 4. Secondary DM - damage to islets 4. ⬆️ risk for panc carcinoma
|
|
|
Pancreatic ca |
Adenoca arising from pancreatic ducts Commonly seen in elderly Major risk factors: smoking and chronic pancreatitis
Present late in course Epigastric abd pain and wt loss Head of pancreas involved - obstructive jaundice with pale stools and palpable gallbladder Body or tail involved - sec DM
---- so thin elderly person that suddenly presents with diabetes, suspect pancreatic ca! |
|
|
Pancreatic Ca additional features |
Migratory thrombophlebitis (trosseau sign) - swelling, erythema, and tenderness of extremities (seen in 10% of patients) Serum tumor marker CA 19-9
Tx: whipple procedure (en bloc removal of head, neck of pancreas, proximal duodenum and gallbladder |
