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chr pancreatitis complications .pdf



Original filename: chr pancreatitis complications.pdf
Title: Pseudocysts
Author: Birdem

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CHRONIC PANCREATITIS
&
ITS COMPLICATIONS
DR. MD. MAMUNUR RASHID
ASSOCIATE PROFESSOR & HEAD
HEPATO-BILIARY-PANCREATIC SURGERY

PHYSIOLOGY
Dual Gland
a. Exocrine: secrets digestive enzymes.
• About 98% of weight of pancreas
Water, HCO3 & Enzymes

b. Endocrine: Islets of Langerhans





About 2% of weight of pancreas
A Cell Glucagon
B Cell Insulin.
D Cell Somatostatin
(inhibition of insulin, glucagon & other secretions.)

Common Diseases of Pancreas
 PANCREATITIS
• Acute
• Chronic

 PANCREATIC TUMOURS
• Benign
• Malignant

 PANCREATIC CYSTS
• True Cysts
• Pseudocyst

Chronic Pancreatitis
Chronic inflammatory disease in which there is irreversible
progressive destruction of pancreatic tissue characterized by
functional loss and progressive fibrosis of the pancreas.

Incidence
o 2-10 Per 100,000 population per year
oIn Kerala 1 per 793 inhabitant.

Aetiology
 Obstructive Pancreatitis
• Ductal obstruction - stone, tumour, stricture, malformation,
(annular pancreas, pancreatic divisum)
 Calcificlithiasis
• Alcohol, tobacco,malnutrition, hypercalcaemia, hereditary
 Proteinlithiasis
• Idiopathic (20-40%), Hereditary
 Metabolic disorders (diabetes mellitus, haemachromatosis, hyper
triglyceridaemia)
 Following any episode of acute pancreatitis
 Malnutrition

Clinical feature









Pain radiating to the back, left shoulder
Nausea / vomiting.
Weight loss.
Anangesic dependency
Change of life style.
Steatorrhoea.
Increased incidence of diabetes mellitus
Increased incidence of pancreatic malignancy

Diagnosis
• History
• Clinical Examination
• Evaluation Of Pain (by pain scale)
• Selective Investigations:








Pancreatic enzymes
Plain X-ray Abdomen.
Ultrasonography
CT Scan of HBS & Pancreas
MRCP (Magnetic Resonance Cholangio-Pancreatography)
ERCP
Endocrine / Exocrine function test


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