Pancreas

• What is the embryology of the pancreas ?

  One dorsal and one ventral bud, each with a duct, fuse to form pancreas
• What is the duct in the dorsal bud called ?

  main pancreatic duct
• What portion of duct may persist after fusion of dorsal and ventral bud ?

  accessory duct
• What is the most common pancreas congenital anomaly ?

  Pancreatic divisum
• What is Pancreas Divisum ?

  A congenital anomaly where the dorsal and ventral pancreatic buds fail to fuse during development; separate drainage of the main and accessory pancreatic ducts
• What is an annular pancreas ?

  Pancreatic head surrounds second portion of duodenum; associated with complete or partial atresia of the duodenum
• What other congenital anomalies is annular pancreas associated with ?

  duodenal stenosis or atresia, down syndrome, or tracheoesophageal fistula
• What is ectopic pancreas tissue ?

  Pancreatic tissue grows in other organs such the duodenum, large or small intestine
• How can ectopic pancreatic tissue cause problems ?

  Can still develop acute pancreatitis because it is still functional tissue
• The pancreas empties enzymes into ducts and hormones into the bloodstream.
• What are the pancreatic cells that secrete enzymes called ?

  Acinar cells
• What are the pancreatic cells that release hormones called ?

  Islets of Langerhans
• What are the exocrine enzymes of the pancreas ?

  Amylase, lipase, and trypsinogen/chymotrypsinogen
• What are the endocrine hormones of the pancreas ?

  Insulin, glucagon, somatostatin
• What cells produce insulin ?

  beta cells
• What cells produce glucagon?

  alpha cells
• What cells produce somatostatin ?


  Delta cells
• What does insulin do ?

  Brings blood glucose levels down by converting it into glycogen for storage from liver
• What does glucagon do ?

  Converts glycogen into glucose
• What does somatostatin do ?

  regulates insulin and glucagon
• In what kind of pancreatitis would amylase be elevated ?

  Acute pancreatitis
• What does amylase do ?

  Aids in digestion of carbohydrates
• In what kind of pancreatitis would lipase be elevated ?

  Chronic pancreatitis
• Gallstones in CBD is a common cause of pancreatitis
• Normal pancreatic duct measures 2 mm
• The tail of the pancreas is more superior than the head.
• What is the most common lethal genetic defect of the pancreas in the caucasian population ?

  Cystic fibrosis
• In cystic fibrosis, the pancreas will be echogenic despite cystic elements
• Cystic fibrosis will result in decreased enzyme function
• In cystic fibrosis, the pancreas appears hyperechoic and small in size
• Acute pancreatitis can look normal on ultrasound and therefore hard to diagnose
• Acute pancreatitis is characterized by an enlarged, edematous gland
• Why is it possible for alcohol in patients blood to inflame pancreas ?

  The pancreas has no capsule covering it