Dr Ajesh Bansal

PANCREATIC diseases

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ACUTE PANCREATITIS

Acute pancreatitis is inflammation of the pancreas. The pancreas is a gland that sits just behind the stomach It has two roles

  • To secrete digestive juices into the small bowel to digest food and neutralize gastric acid secretion and
  • to release insulin to regulate the glucose levels in the blood. 
There are three types of pancreatic cells
  • acinar cells, which produce pancreatic digestive enzymes
  • ductal cells lining pancreatic ducts, which secrete a watery fluid to carry the digestive enzymes into the intestine.
  • endocrine cells present in theislets of Langerhans, which secrete insulin and other hormones.

 Pancreatic digestive enzymes are made as inactive precursors and carried to the small bowel where there are additional enzymatic processes that convert the inactive digestive enzymes to actives ones that digest our food. When pancreatic enzymes are prematurely activated in the pancreas, they attack the pancreas itself instead of digesting food and cause pancreatitis.

Tests and procedures used to diagnose pancreatitis include
  • Blood tests to look for elevated levels of pancreatic enzymes
  • Stool tests in chronic pancreatitis to measure levels of fat that could suggest your digestive system isn't absorbing nutrients adequately
  • Computerized tomography (CT) scan to look for gallstones and assess the extent of pancreas inflammation
  • Abdominal ultrasound to look for gallstones and pancreas inflammation
  • Endoscopic ultrasound to look for inflammation and blockages in the pancreatic duct or bile duct
  • Magnetic resonance imaging (MRI) to look for abnormalities in the gallbladder, pancreas and ducts>
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CHRONIC PANCREATITIS

Chronic pancreatitis is a long-standing inflammation of the pancreas that alters the organ's normal structure and functions.  It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. It is a disease process characterized by irreversible damage to the pancreas as distinct from reversible changes in acute pancreatitis.

Symptoms
  • Upper abdominal pain: Upper abdominal pain which increases after drinking or eating, lessens when fasting or sitting and leaning forward. Some people may not suffer pai
  • Nausea and vomiting
  • Steatorrhea: Frequent, oily, foul-smelling bowel movements. Damage to the pancreas reduces the production of pancreatic enzymes that aid digestion, which can result in malnutrition. Fats and nutrients are not absorbed properly, leading to loose, greasy stool known as steatorrhea.
  • Weight loss even when eating habits and amounts are normal.
  • Diabetes type 1: Chronic pancreatitis can affect the ability of the pancreatic islets to produce insulin to regulate glucose levels, leading to diabetes type 1 Symptoms of diabetes type 1 include increased hunger and thirst, frequent urination, weight loss, and fatigue.
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PANCREATIC TUMORS

Pancreatic Tumor begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar.

Pancreatic Tumor typically spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic Tumor is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back.

Symptoms
  • Pain in the upper abdomen that radiates to your back
  • Loss of appetite or unintended weight loss
  • Depression
  • New-onset diabetes
  • Blood clots
  • Fatigue
  • Yellowing of your skin and the whites of your eyes (jaundice)
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PANCREATIC PSEUDOCYST

A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreaticenzymes, blood, and necrotic tissue, typically located in the lesser sac of the abdomen. Pancreatic pseudocysts are usually complications of pancreatitis, although in children they frequently occur following abdominal trauma.

A pancreatic pseudocyst is a collection of tissue and fluids that forms on your pancreas. Your pancreas is located behind your stomach.

Pseudocysts usually form as the result of a hard blow to your abdomen or an inflammation of the pancreas known as pancreatitis.

Pseudo” means false. A pseudocyst looks like a cyst but is made from different kinds of tissue than a true cyst. A true cyst is more likely to be cancerous than a pseudocyst.

A pancreatic pseudocyst isn’t usually dangerous unless it ruptures. A ruptured pancreatic pseudocyst is a life-threatening condition. See your doctor immediately if you have any of the following symptoms:

  • high, persistent fever
  • severe pain in your upper abdomen, with pain radiating to your back
  • unexplained fainting
  • vomiting blood
  • weak, rapid heartbeat