Hepatic, Pancreatic, & Biliary Systems Flashcards

Flashcards about the Hepatic, Pancreatic, & Biliary Systems.

Bile

Yellow to green fluid formed by the liver, approximately 500ml to 1L produced daily.

Gallbladder

Organ that stores bile, with a capacity of 50-100ml.

Function of Bile

Emulsifies fat in the small intestine, aids digestion of fat-soluble vitamins, neutralizes acidic chyme, excretes bilirubin & cholesterol, and acts as a bactericide.

Cholecystokinin

Stimulates gallbladder contraction, pancreatic enzyme secretion, slows gastric emptying, and promotes satiety.

Cholelithiasis

The presence of gallstones, affecting 10-15% of adults.

Epidemiology of Gallstone Disease

Higher incidence in females compared to males, and certain ethnic groups such as American Indians and Hispanics.

Symptoms of Gallstone Disease

Symptoms include referred pain in the right upper quadrant, sternum, and back, often postprandial, including flatulence, belching, and epigastric discomfort.

Medical Management of Gallstone Disease

Management includes antibiotics, dyslipidemics, surgery (laparoscopy/endoscopy), and ERCP.

Two Main Functions of the Pancreas

Includes endocrine and exocrine functions.

Endocrine Function of the Pancreas

Islets of Langerhans (10-20% of pancreatic cells) secrete hormones such as amylin, ghrelin, pancreatic polypeptide, and somatostatin.

Exocrine Function of the Pancreas

Acinar cells (80-90%) secrete zymogen/pro-enzymes (proteases, lipases, amylases), and ductal cells secrete bicarbonate-rich fluid.

Acute Pancreatitis

Characterized by "auto-digestion", often caused by alcohol consumption or physical plugs that activate trypsinogen, leading to increased trypsin and inflammation.

Symptoms of Acute Pancreatitis

Referred pain to the back, acute respiratory distress, and elevated serum amylase, lipases, WBC, and CRP.

Systemic Complications of Acute Pancreatitis

Includes inflammation and ischemia, leading to kidney failure, liver failure, and respiratory distress.

Chronic Pancreatitis

Characterized by persistent inflammation leading to endocrine and exocrine dysfunction.

Causes of Chronic Pancreatitis

Idiopathic, alcohol, calcification, genetic factors, auto-immune issues, or obstruction.

Clinical Complications of Chronic Pancreatitis

Steatorrhea and pancreatogenic diabetes mellitus (Type 3C DM)

Medical Management of Chronic Pancreatitis

Chronic abdominal pain, managed with surgical/nerve blocks, anti-depressants, lifestyle alterations, pancreatic enzyme replacement therapy, and smoking/alcohol cessation.