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PANCREAS PowerPoint Presentation

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Description : Check out this medical presentation on Hereditary Pancreatitis, which is titled "Pancreas", to know about pancreas and its intimate relationship with the duodenum.

Tags : Hereditary Pancreatitis, Pancreas, duodenum

Published on : May 18, 2021 | Views : 4023 | Downloads : 12

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PANCREAS
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OBJECTIVES Understand the etiology/risk factors, pathogenesis, morphology, clinical features and outcome of pancreatic inflammations and neoplasms
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Ventral Bud
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Chapter 19
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Posterior view of duodenum/pancreas
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Arterial supply and venous drainage of the pancreas and spleen
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Lymphatic drainage of the distal pancreas and spleen
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Hepaticopancreatic ampulla (Ampulla of Vater)
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L2
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makes HCO3¯
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Pancreatic Enzymes Amylase Lipase DNA-ase RNA-ase Zymogens: Trypsinogen Chymotrypsinogen Procarboxypeptidase A, B
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PANCREAS DISEASES Congenital Inflammatory Acute Chronic Cysts Neoplasms
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Congenital Agenesis (very rare) Pancreas Divisum (failure of 2 ducts to fuse) (common) Annular Pancreas (pancreas encircles duodenum) (rare) Ectopic Pancreas (very common)
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PANCREATITIS ACUTE (VERY SERIOUS) CHRONIC (Calcifications, Pseudocyst)
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CONSEQUENCES of ACUTE and CHRONIC pancreatitis
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ACUTE PANCREATITIS ALCOHOLISM Bile reflux Medications (thiazides) Hypertriglyceridemia, hypercalcemia Acute ischemia Trauma, blunt, iatrogenic Genes: PRSS1, SPINK1 Idiopathic, 10-20%
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CLINICAL FEATURES ABDOMINAL PAIN EXTREME emergency situation HIGH mortality …but MOST important lab test is……….????? 
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AMYLASE !!!!!!!
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MORPHOLOGY EDEMA FAT NECROSIS ACUTE INFLAMMATORY INFILTRATE PANCREAS AUTODIGESTION BLOOD VESSEL DESTRUCTION “SAPONIFICATION” (stearates, Na+, Ca++)
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CHRONIC PANCREATITIS Pancreatic duct obstruction, LONGSTANDING Tropical Hereditary (PRSS1, SPINK1 mutations) IDIOPATHIC (40%)
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CHRONIC PANCREATITIS
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CLINICAL FEATURES Abdominal Pain Vague abdominal symptoms Nothing CT calcifications (why?), amylase elevated, chronic diarrhea if chronic pancreatic insuffiency develops, high likelihood of pseudocysts
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PDEUDOCYSTS Why “pseudo”? STRONGLY linked with pancreatitis Can be as big as a football and often are. Can cause obstruction Can get infected Do NOT become malignant
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Pancreas Neoplasms Serous Mucinous Cystic Microcystic Papillary Benign Malignant (dense sclerosis is the rule)
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SEROUS CYSTADENOMA
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MUCINOUS CYSTADENOMA
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INTRADUCTAL PAPILLARY MUCINOUS “NEOPLASM”
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CARCINOGENESIS of PANCREATIC ADENOCARCINOMA
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Pancreatic CA
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Pancreatic Adenocarcinoma
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FATE: Regional lymph nodes Liver Often L-2 spine Lungs Grading (WMP), Staging, TNM
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Final TIP of the day Painless jaundice in an elderly person is CARCINOMA of the head of the pancreas until proven otherwise