7/27/2019 Ch19 Pancreas 1

1/50

PANCREAS

7/27/2019 Ch19 Pancreas 1

2/50

PANCREAS

7/27/2019 Ch19 Pancreas 1

3/50

7/27/2019 Ch19 Pancreas 1

4/50

7/27/2019 Ch19 Pancreas 1

5/50

Ventral Bud

7/27/2019 Ch19 Pancreas 1

6/50

7/27/2019 Ch19 Pancreas 1

7/50

7/27/2019 Ch19 Pancreas 1

8/50

7/27/2019 Ch19 Pancreas 1

9/50

Chapter 19

7/27/2019 Ch19 Pancreas 1

10/50

Posterior view of duodenum/pancreas

7/27/2019 Ch19 Pancreas 1

11/50

Arterial supply and venous drainage of the

pancreas and spleen

7/27/2019 Ch19 Pancreas 1

12/50

Lymphatic drainage of the distal

pancreas and spleen

7/27/2019 Ch19 Pancreas 1

13/50

7/27/2019 Ch19 Pancreas 1

14/50

Hepaticopancreatic ampulla

(Ampulla of Vater)

7/27/2019 Ch19 Pancreas 1

15/50

L2

7/27/2019 Ch19 Pancreas 1

16/50

7/27/2019 Ch19 Pancreas 1

17/50

7/27/2019 Ch19 Pancreas 1

18/50makes HCO3

7/27/2019 Ch19 Pancreas 1

19/50

7/27/2019 Ch19 Pancreas 1

20/50

7/27/2019 Ch19 Pancreas 1

21/50

Pancreatic Enzymes Amylase Lipase

DNA-ase RNA-ase

Zymogens: TrypsinogenChymotrypsinogenProcarboxypeptidase A, B

7/27/2019 Ch19 Pancreas 1

22/50

PANCREAS DISEASES

CongenitalInflammatory

Acute

Chronic

Cysts

Neoplasms

7/27/2019 Ch19 Pancreas 1

23/50

Congenital Agenesis (very rare)

Pancreas Divisum (failure of 2ducts to fuse)(common)

Annular Pancreas (pancreasencircles duodenum)(rare)

Ectopic Pancreas (very common)

7/27/2019 Ch19 Pancreas 1

24/50

7/27/2019 Ch19 Pancreas 1

25/50

7/27/2019 Ch19 Pancreas 1

26/50

PANCREATITIS ACUTE (VERY SERIOUS)

CHRONIC (Calcifications,Pseudocyst)

7/27/2019 Ch19 Pancreas 1

27/50

7/27/2019 Ch19 Pancreas 1

28/50

7/27/2019 Ch19 Pancreas 1

29/50

CLINICAL FEATURES

ABDOMINAL PAIN

EXTREME emergency situation

HIGH mortality

but MOST important lab testis.?????

7/27/2019 Ch19 Pancreas 1

30/50

AMYLASE

!!!!!!!

7/27/2019 Ch19 Pancreas 1

31/50

7/27/2019 Ch19 Pancreas 1

32/50

7/27/2019 Ch19 Pancreas 1

33/50

7/27/2019 Ch19 Pancreas 1

34/50

CHRONIC PANCREATITIS

Pancreatic duct obstruction,LONGSTANDING

Tropical Hereditary (PRSS1, SPINK1

mutations) IDIOPATHIC (40%)

7/27/2019 Ch19 Pancreas 1

35/50

7/27/2019 Ch19 Pancreas 1

36/50

7/27/2019 Ch19 Pancreas 1

37/50

CHRONIC PANCREATITIS

7/27/2019 Ch19 Pancreas 1

38/50

7/27/2019 Ch19 Pancreas 1

39/50

7/27/2019 Ch19 Pancreas 1

40/50

7/27/2019 Ch19 Pancreas 1

41/50

7/27/2019 Ch19 Pancreas 1

42/50

7/27/2019 Ch19 Pancreas 1

43/50

SEROUS

CYSTADENOMA

7/27/2019 Ch19 Pancreas 1

44/50

7/27/2019 Ch19 Pancreas 1

45/50

INTRADUCTAL

PAPILLARY

MUCINOUS

NEOPLASM

7/27/2019 Ch19 Pancreas 1

46/50

7/27/2019 Ch19 Pancreas 1

47/50

Pancreatic CA

7/27/2019 Ch19 Pancreas 1

48/50

Pancreatic

Adenocarcinoma

FATE

7/27/2019 Ch19 Pancreas 1

49/50

FATE: Regional lymph nodes

Liver

Often L-2 spine Lungs

Grading (WMP) Staging TNM

7/27/2019 Ch19 Pancreas 1

50/50