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EXOCRINE PANCREAS - Coggle Diagram

- - - - Etiology
        
        Etiology:
        
        Most common: Alcohol & Gallstones
        
        Other: Trauma, Hypercalcemia,
        Hyperlipidemia, drugs, scorpions
        stings, mumps, rupture of
        a posterior duodenal ulcer
        
        Clinical Features:
        
        Epigastralgia→radiates to the back
        
        Nausea and vomiting
        
        Periumbilical and flank hemorrhage (necrosis spreads into the periumbilical soft tissue and retroperitoneum)
        
        ↑↑ serum lipase and amylase; lipase more specific
        
        ↓↓ Ca+ (calcium consumed in saponification→fat necrosis)
        
        Complications:
        
        Shock →peripancreatic hemorrhage and fluid sequestration
        
        Pancreatic pseudocyst → fibrous tissue surrounding liquefactive necrosis & ↑↑pancreatic enzymes → abdominal mass + persistently ↑↑ amylase; Rupture→ release of enzymes into the abdominal cavity and hemorrhage.
        
        Pancreatic abscess→E coli → abdominal pain, high fever, and persistently ↑↑ amylase
        
        DIC and ARDS
- - - - Clinical features:
        
        Epigastralgia→radiates to the back
        
        Tumor pancreas head: Obstructive jaundice + pale stools and palpable gallbladder (most common type)
        
        Tumor pancreas body or tail → DM
        
        Pancreatitis
        
        Trousseau syndrome: Migratory thrombophlebitis → swelling +
        erythema + tenderness in the extremities (seen in 10%)
        
        Serum tumor marker is CA 19-9.
      - Tx: Whipple procedure:
        bloc removal of pancreas
        head & neck + proximal
        duodenum + gallbladder