CH.12 PANCREAS

acini cells

• perform exocrine functions

• small sac clusters connected by small ducts that connect to large excretory ducts

• Up to 2L of juice made per day

Amylase

carb digesting enzyme

Duct of Santorini

• drains upper anterior head

• enters duodenum at minor papilla

• secondary duct

duct of wirsung

• extends entire length of gland

• enters duodenum at ampulla

• primary duct

duct of wirsung

measures 2mm or less

endocrine

hormonal function

exocrine

digestive function

glucagon

• formed by alpha cells in islets

• hormone that makes cells release glucose

• stimulates liver to convert stored glycogen to released glucose to increase sugar levels

Hypercalcemia

• elevated calcium levels

• predisposed to chronic pancreatitis

Hyperlipidemia

• elevated fat levels

• predisposed to chronic pancreatitis

insulin

produced by beta cells

islets of langerhans

• used in endocrine functions

• hold specialized Alpha, Beta, and Delta cells

lipase

enzyme that digests fats

ascites

occurs when pseudocyst ruptures into the abdomen

pseudocyst

walled-off fluid collection caused from inflammation, necrosis, trauma, and hemorrhage

uncinate process

small curved tip at end of head

celiac axis

• three branches: left gastric, common hepatic, and splenic arteries

• originates from anterior abdominal aorta

superior mesenteric artery

• from aorta, courses anterior

• enters 3rd portion of duodenum to enter small bowel mesentery

pancreas divisum

• rare congenital condition

• caused by lack of fusion of dorsal and ventral pancreatic buds

ectopic pancreatic tissue

• congenital anomaly showing intramural nodules

• can be found throughout GI tract

• feel like polyps with central dimple

• 0.5-2cm tumors and acute pancreatitis can occur in them

annular pancreas

rare anomaly where head surrounds second portion of duodenum

courvoisier sign

jaundice w/ gallbladder hydrops (gallbladder dilation)

acute pancreatitis

• inflamed acini cells release enzymes into surrounding tissue

• usually come w/ history of gallstones or alcoholism

• hypoechoic texture

• irregular borders

• enlarged head and pancreatic duct

• gallstones

• fluid collection

• leukocytosis

hemorrhagic pancreatitis

rapid progression of acute pancreatitis with rupture of pancreatic vessels

phlegmonous pancreatitis

• hypoechoic texture

• irregular borders

• enlarged head and pancreatic duct

• HYPOECHOIC ILL-DEFINED MASS

• gallstones

• fluid collection

• leukocytosis

pancreatic absess

• develops often post-op

• related to necrosis and nearby infection

• HYPOECHOIC MASS W/ SMOOTH BORDERS

• THICK WALLS

• increased leukocytosis

chronic pancreatitis

• recurrent acute pancreatitis attacks causing permanent damage

• limited endocrine and exocrine functioning

• weight loss

• fatty stool

• diabetes signs

• SMALL FIBROTIC GLAND

• MIXED ECHOGENICITY

• JAUNDICE

• increased enzymes

autosomal polycystic disease

multiple cysts in kidney and liver extending to pancreas

von hippel-lindau syndrome

• formation of tumors and cysts around the body

• inherited disorder

insulinoma

• islet cell tumor

• B-cell tumor

gastrinoma

• islet tumor than produces Zollinger-Ellison syndrome

• caused by non-insulin tumors

• G-cell tumor