Cancer Pancreas 2 Clinical

7.2 CLINCIAL MANIFESTION

Periampullary  carcinomas  of the head of  the  pancreas  present

with:

*  Jaundice with a palpable gall bladder (Courvoisier's law)

   Fig.22.3)

*  Pain

*  Weight loss and a mass

7.3 CARCINOMA OF BODY

Radiation  of pain to the back is seen in both carcinoma  of  the

head and body.

*  Pain is extremely frequent in carcinomas of the body and tail

*  Progressive  jaundice,  anorexia and weakness  are  the  other

   presentations

*  Diarrhoea, constipation and pruitis may also be seen

*  In jaundice cases, chills and fever are common

7.4 DIAGNOSIS

Investigations  for jaundice and other liver function  tests  are

required.

An ultrasound or CT may help to establish the diagnosis.

An  endoscopy  to  view  the ampulla of  vater  and  an  ERCP  to

demonstrate the anatomy of biliary and pancreatic ducts can  also

help the diagnosis

Any questions be sent to drmmkapur@gmail.com

Allolder posts are stored in archives for access and review.

Visitors that follow may podtcontributions to the site,please write to address above.

To create consumer/provider engagement visit www.otmanage.blogspot.com

www.surginstruatlas.blogspot.com             www.drmmkapur.blogspot.com

Tumors CANCER PANCREAS 1

TUMOURS                       PANCREATIC CARCINOMA                    

                                                                     Common presenting features              

CARCINOMA OF THE PANCREAS           * Substantial weight loss               

                                                                             (about 80%)                           

Average  age of  patients                                  * Abdominal pain(about 60%)             

with  adenocarcinoma   is                                 * Obstructive jaundice,                 

sixty years.                                                       often without pain                     

                                                                         (about 50%)                           

Ninty     percent      of                                   Less common features                    

adenocarcinomas are  from                             * Acute pancreatitis(15%)               

the  exocrine   secreting                                  * Diabetes mellitus                     

ductal   cells   of   the                                        (preceding for following              

pancreas  about  5%   are                                   carcinoma)                            

tumours    of    acinenon                                * Gastric outlet obstruction            

exocrine cells, about 20%                                    (due to external                      

are   tumours   of    the                                          compression)                          

endocrine   islet   cells                                    * Thrombophlebitis migrans              

these manifest by secreting excess hormones(insulin, glucogon  or

gastrin)

Males are frequently affected

Cause is unknown

ANY QUESTION be sent to drmmkaur@gmail.com

All older posysare stored in archives for access and review.

Visitors that follow may post contributions to the site,please write to address above.

To create consumer/provider engagement visit www.otmanage.blogspot.com    

www.surginstruatlas.blogspot.com           www.drmmkapur.blogspot.com

Cysts Pancreas 1

 CYSTS

Three-quarters  of  all  cystic  lesions  in  the  pancreas   are

pseudocytsts.

Pancreatitis and trauma are important causes of pseudocysts.

*  In  a pseudocyst a fibrous tissue wall surrounds a  collection

   of escaped pancreatic juice (with or without a blood clot)

*  They are unilocular and situated in the lesser sac.

*  Occasionally  they  occur within the  pancreas  or  transverse

   mesocolon

*  They  result  from a disruption of the ductal  system  of  the

   pancreas.

CLINICAL MANIFESTATIONS :

Presistant pain, fever and ileus appearing 2 to 3 weeks after  an

attack of pancreatitis or trauma are the main symptoms.

-  Pain is in the epigastrium or left upper quadrant

-  A mass is felt on examination

-  Nausea, vomiting or anorexia may also occur

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for access and review.

Visitors that follow may post contributions to the site,please write to address above.

To create consumer/ptovider engagement visit www.drmmkapur.blogspot.com

www.otmanage.blogspot.com                www.surginstruatlas.blogspot.com

Trauma PANCREAS

TRAUMA

Penetrating  trauma  like in gunshot or stab wounds is  the  main

cause.

Blunt  trauma  is responsible in a third of cases and  tears  the

pancreas in two across the vertebral column. Fig. 22.2

*  Patients present with history of trauma

*  Followed by signs of blood loss, peritonitis and shock

*  Pancreatic fistula, pseudocyst or death are usually the result

   of  disruption  of the organ itself or its  ductal  system  in 

   late undiagnosed case.

*  Awareness  of the possibility of this should be kept  in  mind

   when trauma is followed by abdominal pain

   -  evidence of continuing haemorrhage

   -  tenderness and guarding or

   -  fever

5.1 TREATMENT

At the time of exploration of the haematoma, attention should  be

first  directed  towards haemostasis followed by  repair  of  the

injury.

In some cases distal pancreatectomy is required.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for accessed review.

Visitors that follow may post contributions to the site,please write to address above.

To create onsumer/provider engagement visit www.drmmkapur.blogspot.com

www.otmanage.blogspot.com             www.surginstruatlas.blogspot.com