1. Program Power Point Diseases of Pancreas and Spleen 2. ก ก ก Diseases of Pancreas and Spleen
|
|
- Allan Briggs
- 5 years ago
- Views:
Transcription
1 1 ก ก ก ก ก 90 ก ก ก ก 1. ก 2. ก ก 3. ก กก ก ก ก 4. ก ก ก ก 5. ก ก 1. Anatomy and Physiology of Pancreas and Spleen 2. Diagnosis and Treatment of common diseases of Pancreas 2.1 Congenital anomaly : Pancreas Divisum, Ectopic Pancreas, Annular Pancreas 2.2 acute pancreatitis 2.3 chronic pancreatitis 2.4 pancreatic tumor 3. Disease of Spleen that require surgery 2.1 indication for splenectomy 2.2 complication of splenectomy ก ก ก ก 20 ก 1. Program Power Point Diseases of Pancreas and Spleen 2. ก ก ก Diseases of Pancreas and Spleen 1
2 2 (Pancreas) Pancreas ก ก ก 2 PAN KREAS ก retroperitoneal organ anterior pararenal space ก ก ก ก ก 1 ก 4 (head) (neck) superior mesenteric ก (body) (tail) superior mesenteric ก uncinate process ก duct of Wirsung major papilla (papilla of Vater) duct of Santorini minor (accessory) papilla major papilla ก ก ก ก ก celiac axis superior mesenteric artery (SMA) pancreaticoduodenal artery ก splenic artery ก ก celiac superior mesenteric sympathetic greater splanchnic nerve (T5-T10) parasympathetic ก vagus nerve ก sympathetic celiac ganglion ก ก ventral dorsal bud foregut ก embryo ventral bud duodenum ก dorsal bud superior mesenteric artery (SMA) superior mesenteric vein (SMV) ventral bud ก dorsal bud ventral bud ก duct of Wirsung ก dorsal bud ก duct of Santorini ก ampulla of Vater ก (common bile duct; CBD) 2
3 3 (exocrine) (endocrine) ก 20 ก isosmotic ก ก duodenum / active form amylase ( carbohydrate) lipase ( ) inactive form protienase ( ) ก active form enterokinase ก ก ก ก 3 (cephalic phase) ก ก กก ก ก ก ก vagus nerve ก (gastric phase) antrum ก gastrin ก acinar ก ก ก gastropancreatic reflex ก (intestinal phase) ก กก ก ก ก ก ก ก ก ก cholecystokinin (CCK) secretin ก ก ก ก กก islet of Langerhans ก ก ก ก islet of Langerhans ก 1 islet B cell insulin 25 A cell glucagon ก D-cell somatostatin F cell PP cell pancreatic polypeptide ก (congenital anomaly) ก 3 1. (annular pancreas) ก ก ventral bud ก ก ก duodenal obstruction ก ก ก 2 (annular pancrease) 3
4 4 ก ก ก (duodenoduodenostomy) ก (duodenojejunostomy) ก ก ก ก ก ก duodenal obstruction ก duodenojejunostomy 2. Pancreas divisum ventral bud dorsal bud ก duct of Santorini minor papilla ( ก ก major papilla) 10 ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก minor papilla ก 3. Aberrant pancreas ก heterotopic ectopic accessory pancreas ก ก ก mucosa ก Meckel s diverticulum ก ก intussussception ก ก ก ก ก (Pancreatitis) ก ก 2 ก (acute pancreatitis) ก (chronic pancratitis) 1. Acute pancreatitis Atlanta classification 1992 acute pancreatitis Acute inflammatory process of pancreas with variable involvement of other regional tissues or remote organ systems ก ก ก (edematous pancreatitis) ก ก ก ก ก ก ก ก pancreatic necrosis, pancreatic abscess, pseudocyst, hemorrhagic pancreatitis ก ก 1.1 ก 300,000 ( ก ก 300 ) ก ก ก ก ก acute pancreatitis ก กก ก acinar cell ก ก ก duodenum ก fat necrosis ก lipase fatty acid glycerol fatty acid กก ก ก ก (saponification) ก กก ก (hemorrhagic pancreatitis) ก ก ก 4
5 5 acute pancreatitis ก ก ก 1. Biliary tract disease (gallstone pancreatitis, biliary pancreatitis) 2. Alcohol 3. Hyperlipidemia 4. Hereditary 5. Hypercalcemia 6. Trauma(External, Surgical, Endoscopic retrograde cholangiopancreatography) 7. Ischemia(Hypoperfusion, Atheroembolic, Vasculitis) 8. Pancreatic duct obstruction(neoplasms, Pancreas divisum, Ampullary and duodenal lesions) 9. Infections (mumps, coxsackievirus, and Mycoplasma pneumoniae) 10. Venom (scorpion's venom,antiacetylcholinesterase insecticides) 11. Drugs (thiazide diuretics, furosemide, estrogens, azathioprine, L-asparaginase, 6-mercaptopurine, methyldopa, the sulfonamides, tetracycline, pentamidine, procainamide, nitrofurantoin, dideoxyinosine, valproic acid, and acetylcholinesterase inhibitors) 12. Idiopathic 1.2 ก ก ก / 50 ก ก ก ก 75 ก ก ก 38.5 ก ก ก ก / ก ก ก ก ก (ileus) กก ก (oliguria) ก ก ก ก ก ก 2 3 (pleural effusion) ก (mental confusion) ก retroperitoneum (Grey-Turner s sign) (Cullen s sign) 1.3 ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก (biochemical tests) - serum amylase ก ก ก ก ก 3 sensitivity 61% specificity 95% ก ก 3-5 ก ก - serum lipase ก ก ก ก 3 sensitivity % specificity >95% ก ก 7-14 ก ก serum amylase lipase ก 5
6 6 - ก ก ก ampulla ก ก ก ก ก ก กก ก ก ก - ก ก ก ก ก ก colon cutoff sign sentinel loop sign ก ก (ultrasonography; US) ก acute pancreatitis ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก (computed tomography; CT) ก ก ก ก ก (endoscopic retrograde cholangiopancreatography; ERCP) ก ampulla (biliary pancreatitis) ก 48, serum total bilirubin > 4 mg%)ก ก (sphincterotomy) ก ก ก 1.4 ก Ranson's Prognostic Signs of Pancreatitis 11 ( 1) ก ก 93 ก 3 mild pancreatitis ก ก กก severe pancreatitis ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก กก ก (1) ก ก ก ก ก ก ก ก ก กก H2-blocker somatostatin atropine ก ก ก ก ก ก ก 6
7 7 (2) ก ก ก ก ก กก 30 ก ก ก ก ก ก ก ก (peritoneal lavage) ก ก ก (3) ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก Criteria for acute pancreatitis not due to gallstones At admission During the initial 48 h Age >55 y Hematocrit fall >10 points WBC >16,000/mm 3 BUN elevation >5 mg/dl Blood glucose >200 mg/dl Serum LDH >350 IU/L Serum AST >250 U/dL Serum calcium <8 mg/dl Arterial PO 2 <60 mm Hg Base deficit >4 meq/l Estimated fluid sequestration >6 L Criteria for acute gallstone pancreatitis At admission Age >70 y WBC >18,000/mm 3 During the initial 48 h Hematocrit fall >10 points BUN elevation >2 mg/dl Blood glucose >220 mg/dl Serum LDH >400 IU/L Serum AST >250 U/dL Serum calcium <8 mg/dl Base deficit >5 meq/l Estimated fluid sequestration >4 L AST = aspartate transaminase, BUN = blood urea nitrogen, LDH = lactate dehydrogenase, PO 2 = partial pressure of oxygen, WBC = white blood cell count. 1 ก acute pancreatitis Ranson's Prognostic Signs of Pancreatitis 7
8 ก ก (1) ก ก bowel obstruction, mesenteric ischemia/infarction, perforated hollow viscus (2) ก ก ก ก ก ก. ก ก ก ก ก (3) ก ก ก infected necrotizing pancreatitis ( ก Gas bubbles on CT scan,positive bacterial culture ก fine needle aspiration) (pseudocyst) (pancreatic abscess) ก endoscopic percutaneous drainage ก 2. Chronic pancreatitis ก (fibrosis, calcification, stone) 2.1 ก ก ก 5-27 ก ก ก Alcohol 70 Idiopathic (including tropical) 20 (Hereditary, Hyperparathyroidism, Hypertriglyceridemia, Autoimmune pancreatitis, Obstruction, Trauma, Pancreas divisum) 10 ก ก ก ก ก ก (protein plugs) ก ก กก (stone) ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก fibrosis ก 2.3 ก ก ก ก กก ก ก (ductal hypertension ) ก (neural inflammation ) 10 ก ก ก กก ก ก ก ก ก ก ก B cell ก (steatorrhoea) ก lipase ก ก ก ก ก 2.4 ก ก ก ก ก US CT MRI ก ERCP ก 8
9 9 2.5 ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก (1) ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก (2) ก ก ก ก (1) ก / ก ก ก (2) ก ก กก ก duodenal obstruction (3) ก ก ก 2 ก ก ก ก ก ก ก ก ก ก 2 ก ก ก กก 90 ก ก ก ก ก (pancreatic endocrine tumor) ก ก ก ก ก pancreatic adenocarcinoma 1. (pancreatic adenocarcinoma) ก ก ก 30,300 ก ก ก cancer registry ก ก 40 ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก กก 1.1 ก ก ก ก ก ก 2 3 ก ก / ก ก ก ก ก ก ก 9
10 10 ก 30 (Courvoisier s law) ก ก ก ก ก ก ก ก ก ก ก 60 ก ก ก ก ก Trousseau s (migratory thrombophlebitis) ก insulin insulin ก ก ก 1.2 ก ก ก ก (tumor marker) CA 19-9, CA 50, CA 125, Span-1 Du-pan 2 ก (70-95 ) ก CT ก ก ก ก ก ก ก ก ก ก ก ก ก (ERCP) ก ก 90 ก ก ก ก (fine needle aspiration cytology) ก ก ก ก ก ก ก ก ก (laparoscopy) ก ก ก ก ก ก ก ก ก ก ก ก กก ก ก ก ก 1.3 ก ก ก ก ก ก ก ก ก ก ก ก ก (resectional surgery) ก liver metastases, celiac or hepatic hilar lymph node involvement, peritoneal implants, invasion of transverse mesocolon ก ก duodenum (Whipple s operation) ก ก antrum ก CBD ก (distal pancreatectomy) 10
11 11 ก (total pancreatectomy) ก ก ก ก (palliative surgery) ก ก ก ก ก ก ก 3 ก (1) ก (2) กก ก (gastric outlet obstruction) 20 (3) ก / ก กก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก กก ก ก celiac ganglion ก 6 ก (absolute alcohol) ก ก ก ก ก ก (nonoperative palliation) ก ก ก ก ก ก ก ก ก (endoscopic biliary stenting) (percutaneous stenting) ก ก ก ก celiac ganglion ก ก ก กก ก ก ก ก ก ก ก 1 ก ก 5 ก 10 ก 5 2. ก (Pancreatic endocrine tumors) ก 5-10 ก 1-2 ก benign malignant 2.1 (Insulinoma) ก ก ก ก B cell ก กก ก 90 ก ก กก ก multiple endocrine neoplasia (MEN 1) ก ก ก ก insulin ก ก ก กก ก ก ก ก ก ก Whipple s triad ก 1. ก ก ก (fasting period) 2. ก 50 ก /100 ก ก 3. ก ก ก insulin กก 0.4 ก proinsulin C-peptide ก ก insulin ก ก ก ก 11
12 12 ก ก ก CT endoscopic US ก intraoperative US ก ก ก ก ก ก ก ก insulin diazoxide 5-15 ก /ก ก somatostatin ก 2.2 Gastrinoma ก ก ก : = 3:2 ก ก ก immature neuroendocrine precursor กก กก ก ก ก ก 75 ก ก ก ก ก ก ก ก ก ก gastrin ก ก ก ก ก ก ก ก ก CT MRI ก Gastrinoma Triangle (Passaro s Triangle) ก cystic duct, junction 2 nd ก 3 rd part duodenum junction neck ก body pancreas 3 Gastrinoma triangle ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก omeprazole ก ก ก ก ก ก 2.3 VIPoma 3-5 ก VIPoma ก ( ) ก ก (watery diarrhea) ก ก 12
13 Glucagonomas 1 ก ก กก ก ก ก ก A cell กก 60 ก ก ก ก necrotizing migratory erythema ก superficial epidermal bullous ก ก 2.5 Nonfunctioning islet-cell tumors ก ก ก ก ก pancreatic adenocarcinoma ก ก ก Pancreatic cyst ก (1) true cyst 20 cyst epithelium congenital cyst, polycystic disease, retention cyst cystic neoplasm (2) false cyst 80% cyst epithelium ก ก ก ก ก ก ก กก ก ก ก ก cyst ก 13
14 14 (Spleen) Anatomy and Embryology ก ก mesoderm dorsal mesogastrium 5 lymphoid organ ก ก ก ก ( 150 ก ) ก ก ก ก ก ก 3 ก gastrosplenic ligament short gastric ก ก splenorenal ligament ก retroperitoneum splenophrenic ligament splenocolic ligament ก ก 20 ก accessory spleen ก ก hilum gastrocolic ligament greater omentum ก splenic artery celiac axis hilum ก splenic vein ก ก inferior mensenteric vein portal vein ก lymphatic tissue(white pulp) ก red pulp ก macrophage, histiocyte sinusoid ก Sites where accessory spleens are found in order of importance. A. Hilar region, 54%. B. Pedicle, 25%. C. Tail of pancreas, 6%. D. Splenocolic ligament, 2%. E. Greater omentum, 12%. F. Mesentery, 0.5%. G. Left ovary, 0.5%. Physiology 1. filtration ก ml/min ก ก 20 ml 2. immunologic function opzonization, phagocytosis antibody synthesis immunoglobulin M (IgM) 3. storage function ก ก 1/3 (sequestration) ก ก ก ก ก pancytopenia 4. hematopoiesis ก ก ก bone marrow myeloproliferative disorders 14
15 15 ก ก (splenectomy) ก - trauma - non trauma Red blood cell disorders Congenital : Hereditary spherocytosis, Hemoglobinopathies (Sickle cell disease, Thalassemia, Enzyme deficiencies) Acquired : Autoimmune hemolytic anemia, Parasitic diseases Platelet disorders Idiopathic thrombocytopenic purpura (ITP) Thrombotic thrombocytopenic purpura (TTP) White cell disorders Leukemias Lymphomas Hodgkin's disease Bone marrow disorders (myeloproliferative disorders) Myelofibrosis (myeloid metaplasia) Chronic myeloid leukemia (CML) Acute myeloid leukemia (AML) Chronic myelomonocytic leukemia (CMML) Essential thrombocythemia Polycythemia vera Miscellaneous disorders and lesions Infections/abscess Storage diseases/infiltrative disorders: Gaucher's disease, Nieman-pick disease,amyloidosis Felty s syndrome Sarcoidosis Cysts and tumors Portal Hypertension Splenic artery aneurysm ก 338 ก ITP thalassemia ก Splenic trauma ก ก ก ก blunt penetrating ก ก (non operative management: NOM) ก ก ก (splenic repair : splenorrhaphy) ก (partial splenectomy) ก (splenectomy) ก ก ก ก 15
16 16 ก ก (hemodynamic instability) coagulopathy ก ก ก ก ก Hereditary spherocytosis ก ก autosomal dominant ก ก spectrin ก biconcave disc ก ก ก ก ก Splenectomy ก ก ก ก ก ก ก ก ก 4-6 ก ก ก ก ก ก Hereditary elliptocytosis spherocytosis ก ก ก ก ก ก ก Thalassemia ก ก ก hemoglobin(hb) ก thalassemia major ก ก ก ก ก ก ก กก ก ก กก 9 mg/dl iron-chelating agent ก ก hemosiderosis ก iron overload (>200 ml/kg per year) ก ก Sickle cell anemia ก HbS HbA homozygous ก ก (deoxygenated) ก ก ก ก ก ก thrombosis, ischemia, infarction organ fibrosis ก ก ก (crisis) acute abdomen ก ก electrophoresis ก ก ก ก ก ก Autoimmune hemolytic anemia (AIHA) ก ก ก antibodies ก ก hemolytic jaundice secondary AIHA ก ก ก collagen disease primary AIHA primary AIHA antibodies 2 1. IgG ก 2. IgM (cold-reactive antibodies) ก ก ก กก ก AIHA ก anemia reticulocytosis Coomb stest ก 16
17 17 Treatment กก ก ก ก corticosteroid ก 1. primary AIHA ก 2. ก ก Cr-51 RBC scan Idiopathic thrombocytopenic purpura (ITP) ก ก non trauma bleeding disorder platelet ก ก 100,000 cells/cmm anti-platelet factor IgG ก RE system platelet ก ก ก ก ก ก ก platelet ก 20,000 cell/cmm spontaneous bleeding ก ก thrombocytopenia ก megakaryocyte ก bone marrow biopsy ก ก corticosteroid (prednisone 1 ก./กก./ ก platelet ก ก ITP ก 3. ก ก platelet transfusion ก platelet ก accessory spleen ก ก ก ก ITP platelet ก 1-3 corticosteroid 4-6 ก ก immunosuppressant vincristine, cyclophosphamide azathioprine Hodgkin s disease malignant lymphoma Reed-Sternberg cell(multinucleated giant cell) ก ก ก systemic กก ก ก biopsy ก ก ก irradiation local treatment chemotherapy systemic treatment ก ก ก stage staging ก ก Stage I ก Stage II กก ก ก ก ก Stage III กก ก ก ก Stage IV ก ก ( ก Staging laparotomy clinical stage I II ก staging laparotomy ก 1.biopsy celiac axis, lesser omentum, mesentery, paraaortic iliac vessels 2. ก 3. liver biopsy ก ก staging ก ก 17
18 18 ก ก irradiation ก (oophoropexy) ก iliac vessels Malignant lymphoma non-hodgkin s lymphoma ก RE system ก Hodgkin s lymphoma ก ก systemic กก ก ก ก ก staging laparotomy ก ก ก ก ก ก ก ก hypersplenism ก ก ก infarction Chronic leukemia chronic lymphocytic leukemia lymphocyte lymphocytosis ก ก ก ก ก chemotherapy, corticosteroid irradiation chronic myeloid leukemia myeloid cell granulocyte ก ก leukocytosis ก ก ก chemotherapy, irradiation, radioactive phosphorus extracorporeal irradiation ก leukemia hypersplenism ก ก ก Myeloid dysplasia ก progressive fibrosis ก ก ก fibrosis ก ก myeloid leukemia polycythemia vera ก ก ก 1. blood transfusion 2. corticosteroid androgen 3. chemotherapy 4. splenic irradiation 5. splenectomy hypersplenism ก ก ก high-output cardiac failure ก A-V shunt Felty s syndrome ก rheumatoid arthritis granulocytopenia antibodies granulocyte ก Splenic vein thrombosis ก ก ก pseudocyst ก ก ก ก splenic vein ก portal hypertension collateral short gastric veins ก varices ก ก varices ก celiac angiography venous phase ก ก ก varices Splenic abscess ก ก septicemia กก infarction hematoma ก ก ก CT scan ก ก ก ก ก Splenic cyst 18
19 19 - pseudocyst ก ก ก hematoma - true cyst epidermoid cyst ก ก - echinococcal cyst ก กก E. granulosus ก ก ก ก ก ก ก Splenic tumor benign hemangioma, lymphoma harmartoma lymphoma, hemangiosarcoma metastasis ก ก ก ก Splenic artery aneurysm ก ก medial dysplasia ก ก atherosclerosis ก ก ก ก aneurysm ก ก ก ก กก aneurysm ก ก ก ก ก ก splenic artery Wandering spleen ก กก ligament ก ก ก (torsion) pedicle ก ก ก (splenopexy) ก ก torsion infarction Complication for splenectomy Early postoperative complications Bleeding ก ก ก ก ก hematoma ก ก ก ก hematoma ก left lower lobe atelectasis ก 16 pleural effusion, pneumonia Acute pancreatitis ก กก ก pancreatic fistula, pseudocyst ก Deep vein thrombosis Longterm complication Thrombocytosis Recurrent disease ITP ก ก accessory spleen ก Splenosis ก ก กก ก ก peritoneal surface ก ก ก ก Overwhelming postsplenectomy infection (OPSI) ก 5 ก ก ก ก vaccine ก ก ก ก ก 4 ก RE system S. pneumoniae(50-90%), N. meningitis, 19
20 20 H. influenzae ก ก ก ก กก ก 48 ก ก ก ก ก ก ก ก vital signs partial splenectomy ก ก pneumococcal, meningococcal H. influenzae type B vaccine ก 7-14 ก penicillin( ก mg oral q 12 hr, mg oral q 12 hr) amoxicillin( ก 5 10 mg/kg/day, mg/day) 2 ก ก ก ก ก ก 1.. ก ก. ก : ก ก ; กก.. 5 ( ก ). ก : ก ก ; ,. Acute Pancreatitis: Role of Surgery. :, ก,, ก. 37 Update in General Surgery. ก : ก ก ; F. Charles Brunicardi, Dana K. Andersen, Timothy R. Billiar, David L. Dunn, John G. Hunter, Raphael E. Pollock. Schwartz's Surgery. 8 th ed. United States: McGraw-Hill; Courtney Townsend, R Daniel Beauchamp, B Mark Evers. Sabiston Textbook of Surgery. 17 th ed. United States: Townsend; John E. Skandalakis, Gene L. Colborn, Thomas A. Weidman, Roger S. Foster, Jr., Andrew N. Kingsnorth, Lee J. Skandalakis' Surgical Anatomy. 2 nd ed. United States: Paschalidis Medical Publications;
16 April 2010 Resident Teaching Conference. Pancreatitis. W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D.
16 April 2010 Resident Teaching Conference Pancreatitis W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D. Santorini Wirsung anatomy.med.umich.edu/.../ duodenum_ans.html Bud and ductology Ventral pancreatic
More informationThe Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System
SGNA: Back to Basics Rogelio G. Silva, MD Assistant Clinical Professor of Medicine University of Illinois at Chicago Department of Medicine Division of Gastroenterology Advocate Christ Medical Center GI
More information-12. -Renad Habahbeh. -Dr Mohammad mohtasib
-12 -Renad Habahbeh - -Dr Mohammad mohtasib The Gallbladder -The gallbladder has a body, a fundus (a rounded end), a neck, Hartmann s pouch before the neck and a cystic duct that meets the common hepatic
More informationJOHN M UECKER, MD, FACS COMPLEX PANCREATICODUODENAL INJURIES
JOHN M UECKER, MD, FACS COMPLEX PANCREATICODUODENAL INJURIES THE PROBLEM DUODENAL / PANCREATIC INJURIES Difficult to diagnose Not very common Anatomic and physiologic challenges 90% rate of associated
More informationPancreatic Lesions. Valerie Jefford Pediatric Surgery Rounds June 6, 2003
Pancreatic Lesions Valerie Jefford Pediatric Surgery Rounds June 6, 2003 Embryology 4 th week 2 buds of endodermal origin from caudal foregut Dorsal and ventral bud Ventral migrates dorsally with CBD (below/behind
More informationCT 101 :Pancreas and Spleen
CT 101 :Pancreas and Spleen Shikha Khullar,, MD, MPH Division of Radiology University of South Alabama The Pancreas Normal Pancreas 3 Phase Pancreatic CT Non contrast Arterial phase : 30-35 35 second
More informationPancreas and Spleen. Chapter 20
Pancreas and Spleen Chapter 20 Pancreas and Spleen Pancreas Congenital variations Ectopic pancreatic tissue Pancreatic tissue may be functional, but patient is asymptomatic Patient may have Meckel s diverticulum
More informationCase Scenario 1. Discharge Summary
Case Scenario 1 Discharge Summary A 69-year-old woman was on vacation and noted that she was becoming jaundiced. Two months prior to leaving on that trip, she had had a workup that included an abdominal
More informationPancreas & Biliary System. Dr. Vohra & Dr. Jamila
Pancreas & Biliary System Dr. Vohra & Dr. Jamila 1 Objectives At the end of the lecture, the student should be able to describe the: Location, surface anatomy, parts, relations & peritoneal reflection
More informationCLINICAL MANIFESTATIONS AND DIAGNOSIS OF ACUTE PANCREATITIS. Raed Abu Sham a, M.D
CLINICAL MANIFESTATIONS AND DIAGNOSIS OF ACUTE PANCREATITIS Raed Abu Sham a, M.D ACUTE PANCREATITIS Acute inflammatory process of the pancreas that resolves both clinically and histologically. It is usually
More informationManagement of Pancreatic Islet Cell Tumors
Management of Pancreatic Islet Cell Tumors Ravi Dhanisetty, MD November 5, 2009 Morbidity and Mortality Conference Case Presentation 42 yr female with chronic abdominal pain. PMHx: Uterine fibroids Medications:
More informationDevelopment of the Liver and Pancreas
Development of the Liver and Pancreas Professor Alfred Cuschieri Department of Anatomy University of Malta Three glandular buds arise from the distal end of the foregut during the fourth week Day 22 -The
More informationPancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts)
Pancreas Quizzes Quiz 1 1. The pancreas produces hormones. Which type of hormone producing organ is the pancreas? a. Endocrine b. Exocrine c. Both A and B d. Neither A or B 2. Endocrine indicates hormones
More informationLAPAROSCOPIC SPLENECTOMY
LAPAROSCOPIC SPLENECTOMY Strasboug, IRCAD October 2010 Catherine HUBERT Jean François GIGOT Benoît NAVEZ Division of Hepato Bilio Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More informationPancreas and Biliary System
Pancreas and Biliary System Please view our Editing File before studying this lecture to check for any changes. Color Code Important Doctors Notes Notes/Extra explanation Objectives At the end of the lecture,
More informationExocrine functions: secretion of digestive enzymes (eg. lipase, amylase,
Chapter 91 Pancreas Episode Overview: 1. List 10 differential diagnoses for acute pancreatitis 2. List 10 causes of pancreatitis. Which are most common in adults? Which one is most common in pediatrics?
More informationLAPAROSCOPIC SPLENECTOMY
LAPAROSCOPIC SPLENECTOMY Catherine HUBERT Jean François GIGOT Benoît NAVEZ Strasboug, IRCAD October 2011 Division of Hepato Bilio Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More information-Ensherah Mokheemer. -Shatha Al-Jaberi محمد المحتسب- 1 P a g e
9-9 -Ensherah Mokheemer -Shatha Al-Jaberi محمد المحتسب- 1 P a g e Small intestine has three regions: ( االثني عشر( The duodenum The jejunum The ileum Small intestine Duodenum: -c-shaped -The concavity
More informationRadiology Pathology Conference
Radiology Pathology Conference Nadia F. Yusaf, M.D. PGY-3 1/29/2010 Presentation material is for education purposes only. All rights reserved. 2010 URMC Radiology Page 1 of 90 Case 1 60 year- old man presents
More informationPediatric Pancreatic Lesions
Pediatric Pancreatic Lesions Pediatric Surgery Grand Rounds 9 October 2013 Tim Weatherall, PGY2 The University of Tennessee Health Science Center Memphis, TN Disclosures No financial interests to disclose
More informationCommon Bile Duct (CBD)
Liver Last time we talked about the liver and the doctor started by revising some information about it: It has five surfaces. It reaches the 5 th intercostal space ; some books write that it reaches the
More informationDIGESTIVE. CHAPTER 17 Lecture: Part 1 Part 2 BIO 212: ANATOMY & PHYSIOLOGY II
BIO 212: ANATOMY & PHYSIOLOGY II CHAPTER 17 Lecture: DIGESTIVE Part 1 Part 2 Dr. Lawrence G. Altman www.lawrencegaltman.com Some illustrations are courtesy of McGraw-Hill. SMALL INTESTINE DUODENUM > JEJUNUM
More informationVisceral aneurysm. Diagnosis and Interventions M.NEDEVSKA
Visceral aneurysm Diagnosis and Interventions M.NEDEVSKA History 1953 De Bakeyand Cooley Visceral aneurysm VAAs rare, reported incidence of 0.01 to 0.2% on routine autopsies. Clinically important Potentially
More informationFareed Khdair, MD Assistant Professor Chief, Section of Pediatric Gastroenterology, Hepatology, and Nutrition University of Jordan School of Medicine
Fareed Khdair, MD Assistant Professor Chief, Section of Pediatric Gastroenterology, Hepatology, and Nutrition University of Jordan School of Medicine Outline Lecture one : Gut formation Foregut: esophagus,
More informationPancreas composed of 2 parts: 1- exocrine gland 2- endocrine gland
pancreas Pancreas composed of 2 parts: 1- exocrine gland 2- endocrine gland Acute pancreatitis Inflammation of the pancreas associated with acinar cell injury Clinical features: 1-abdominal pain cardinal
More informationPancreatic Benign April 27, 2016
Department of Surgery Pancreatic Benign April 27, 2016 James Choi Dr. Hernandez Objectives Medical Expert: 1. Anatomy and congenital anomalies of the pancreas and pancreatic duct (divisum, annular pancreas
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: UPPER GI & HPB - HEPATIC, PANCREATIC & BILIARY
More informationBILIARY TRACT & PANCREAS, PART II
CME Pretest BILIARY TRACT & PANCREAS, PART II VOLUME 41 1 2015 A pretest is mandatory to earn CME credit on the posttest. The pretest should be completed BEFORE reading the overview. Both tests must be
More informationPANCREATIC CANCER GUIDELINES
PANCREATIC CANCER GUIDELINES North-East London Cancer Network & Barts and the London HPB Centre PROTOCOL FOR MANAGEMENT OF PANCREATIC CANCER (SEPTEMBER 2010) I. PRE-REFERRAL GUIDELINES Screening 1. Offer
More informationTo describe the liver. To list main structures in porta hepatis.
GI anatomy Lecture: 6 د. عصام طارق Objectives: To describe the liver. To list main structures in porta hepatis. To define portal system & portosystemic anastomosis. To list parts of biliary system. To
More informationAnatomy of the SMALL INTESTINE. Dr. Noman Ullah Wazir PMC
Anatomy of the SMALL INTESTINE Dr. Noman Ullah Wazir PMC SMALL INTESTINE The small intestine, consists of the duodenum, jejunum, and illium. It extends from the pylorus to the ileocecal junction were the
More informationThe Spleen. Dr Fahad Ullah
The Spleen BY Dr Fahad Ullah Spleen The spleen is an largest lymphoid organ shaped like a shoe that lies relative to the 9th and 11th ribs and is located in the left hypochondrium. Thus, the spleen is
More informationUnusual Pancreatic Neoplasms RTC 2/11/2011
Unusual Pancreatic Neoplasms RTC 2/11/2011 Objectives Intraductal Papillary Mucinous Neoplasm (IPMN) Mucinous Cystic Neoplasm (MCN) Islet Cell Tumors Insulinoma Glucagonoma VIPoma Somatostatinoma Gastrinoma
More informationCentral role: - Regulating the immune system - Influencing metabolic and endocrine functions
Spleen Central role: - Regulating the immune system - Influencing metabolic and endocrine functions Anatomy: An encapsulated mass of vascular and lymphatic tissue The largest RES organ 9-11 th ribs 4 impressions
More informationPancreas Case Scenario #1
Pancreas Case Scenario #1 An 85 year old white female presented to her primary care physician with increasing abdominal pain. On 8/19 she had a CT scan of the abdomen and pelvis. This showed a 4.6 cm mass
More informationThe Foregut. At first the esophagus is short. but with descent of the heart and lungs it lengthens rapidly
GI embryology 2 The Foregut At first the esophagus is short but with descent of the heart and lungs it lengthens rapidly The muscular coat, which is formed by surrounding splanchnic mesenchyme, is striated
More informationMulti modality Imaging in Acute Pancreatitis. Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009
Multi modality Imaging in Acute Pancreatitis Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009 Our Patient R: Introduction 52M with 10d history of nausea, vomiting
More informationDevelopment of pancreas and Small Intestine. ANATOMY DEPARTMENT DR.SANAA AL-AlSHAARAWY DR.ESSAM Eldin Salama
Development of pancreas and Small Intestine ANATOMY DEPARTMENT DR.SANAA AL-AlSHAARAWY DR.ESSAM Eldin Salama OBJECTIVES At the end of the lecture, the students should be able to : Describe the development
More informationDiseases of exocrine pancreas
Diseases of exocrine pancreas The exocrine pancreas constitutes 80% to 85% of the organ and is composed of acinar cells that secrete enzymes needed for digestion. the accessory duct of Santorini, the main
More informationAppendix 9: Endoscopic Ultrasound in Gastroenterology
Appendix 9: Endoscopic Ultrasound in Gastroenterology This curriculum is intended for clinicians who perform endoscopic ultrasonography (EUS) in gastroenterology. It includes standards for theoretical
More informationThe abdominal Esophagus, Stomach and the Duodenum. Prof. Oluwadiya KS
The abdominal Esophagus, Stomach and the Duodenum Prof. Oluwadiya KS www.oluwadiya.com Viscera of the abdomen Abdominal esophagus: Terminal part of the esophagus The stomach Intestines: Small and Large
More informationPancreas (non-endocrine) (see also: biliary/pancreatic folios => pancreas)
Pancreas (non-endocrine) (see also: biliary/pancreatic folios => pancreas) Physiology ductal system produces bicarb, high carbonic anhydrase secretin primary stimulus duodenal enterokinase activates trypsin
More informationد. عصام طارق. Objectives:
GI anatomy Lecture: 5 د. عصام طارق Objectives: To describe anatomy of stomach, duodenum & pancreas. To list their main relations. To define their blood & nerve supply. To list their lymph drainage. To
More information5/17/2013. Pancreatic Cancer. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Case presentation. Differential diagnosis
Overview Case presentation Postgraduate Course in General Surgery Differential diagnosis Diagnosis and therapy Eric K. Nakakura Koloa, HI March 26, 2013 Outcomes CASE 1: CASE 1: A 78-year-old man developed
More informationEvaluation of Suspected Pancreatic Cancer
Evaluation of Suspected Pancreatic Cancer October 15, 2015 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: 1-866-779-3239 Toll
More informationSmall Plicae Circularis. Short Closely packed together. Sparse, completely absent at distal part Lymphoid Nodule
Intestines Differences Between Jejunum and Ileum Types Jejunum Ileum Color Deeper red Paler pink Calibre Bigger Smaller Thickness of wall Thick and Heavy Thin and Lighter Vascularity Highly vascularised
More information4/9/2018 OBJECTIVES PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS
PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS Jean Yves Sewah Kaiser Permanente West Los Angeles 1 OBJECTIVES Discuss the role of ultrasound in the evaluation of the gallbladder, biliary tree and
More informationAppendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound
EFSUMB Newsletter 87 Examinations should encompass the full range of pathological conditions listed below A log book listing the types of examinations undertaken should be kept Training should usually
More informationDisorders of Blood Cells & Blood Coagulation
Disorders of Blood Cells & Blood Coagulation HIHIM 409 WBC count RBC count WBC differential Hemoglobin (HGB) Hematocrit (HCT) % of volume occupied by RBCs CBC Red cell indices Mean cell volume (MCV) average
More informationDone by: nisreen obeidat
Sheet: liver and pancreas Done by: nisreen obeidat Embryology of the liver The liver develops in the ventral mesentery of the foregut and divides the ventral mesentery :into 1)lesser omentum (between the
More informationAnatomy: Know Your Abdomen
Anatomy: Know Your Abdomen Glossary Abdomen - part of the body below the thorax (chest cavity); separated by the diaphragm. Anterior - towards the front of the body. For example, the umbilicus is anterior
More information3/28/2012. Periampullary Tumors. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Eric K. Nakakura Ko Olina, HI
Overview Postgraduate Course in General Surgery Case presentation Differential diagnosis Diagnosis and therapy Outcomes Principles of palliative care Eric K. Nakakura Ko Olina, HI March 27, 2012 CASE 1:
More informationDr. Zahiri. In the name of God
Dr. Zahiri In the name of God small intestine = small bowel is the part of the gastrointestinal tract Boundaries: Pylorus Ileosecal junction Function: digestion and absorption of food It receives bile
More informationPANCREAS DUCTAL ADENOCARCINOMA PDAC
CONTENTS PANCREAS DUCTAL ADENOCARCINOMA PDAC I. What is the pancreas? II. III. IV. What is pancreas cancer? What is the epidemiology of Pancreatic Ductal Adenocarcinoma (PDAC)? What are the risk factors
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: UPPER GI & HPB - HEPATIC, PANCREATIC & BILIARY
More informationPenetrating abdominal trauma clinical view. Ari Leppäniemi, MD Department of Abdominal Surgery Meilahti hospital University of Helsinki Finland
Penetrating abdominal trauma clinical view Ari Leppäniemi, MD Department of Abdominal Surgery Meilahti hospital University of Helsinki Finland Meilahti hospital - one of Helsinki University hospitals -
More informationDuodenum retroperitoneal
Duodenum retroperitoneal C shaped Initial region out of stomach into small intestine RETROperitoneal viscus Superior 1 st part duodenal cap ; moves upwards and backwards to lie on the R crura medial to
More informationTreatment of chronic calcific pancreatitis endoscopy versus surgery
Treatment of chronic calcific pancreatitis endoscopy versus surgery 35 - year old ladypresented to LPC Mumbai with intermittent abdominal pain. Pain was intermittent, colicky, more in epigastrium and periumbilical
More informationStomach. R.B. Kolachalam, MD
Stomach R.B. Kolachalam, MD Relevent Anatomy 1.four regions: Cardia, Fundus, Body, and the Pylorus 2. fixed in two locations- at the GEJ and the duodenum Gastric Anatomy body of the stomach: site of mechanical
More informationCaring for the Patient with Acute Pancreatitis. Disclosure. Objectives
Caring for the Patient with Acute Pancreatitis Bruce D. Askey, MS, ANP-BC Associate Lecturer Fitzgerald Health Education North Andover, MA Adult Nurse Practitioner Dept. of Hepatology/Gastroenterology
More informationPerforation of a Duodenal Diverticulum. Elective Student S. C.
Perforation of a Duodenal Diverticulum 2008 4 Elective Student S. C. Case History An elderly male presented to the Emergency Department with abdominal pain. Chief Complaint: Worsening, diffuse abdominal
More informationGASTROINTESTINAL IMAGING STUDY GUIDE
GASTROINTESTINAL IMAGING STUDY GUIDE Pharynx Diverticula Foreign bodies Trauma o Motility Disorders Esophagus Diverticula Trauma Esophagitis Barrett esophagus Rings, webs, and strictures Varices Benign
More information9/21/15. Joshua Pruitt, MD, FAAEM Medical Director, LifeGuard Air Ambulance Iowa PA Society Fall CME Conference September 29, 2015
Unless they prove otherwise. ~Every ED attending ever Joshua Pruitt, MD, FAAEM Medical Director, LifeGuard Air Ambulance Iowa PA Society Fall CME Conference September 29, 2015 AAA with rupture Mesenteric
More informationCase Discussion Splenic Abscess
Case Discussion Splenic Abscess Personal Data Gender: male Birth Date: 1928/Mar/06th Allergy: Mefenamic Smoking: 0.5 PPD for 55 years Alcohol: negative (?) 4 Months Ago Abdominal pain: epigastric area
More informationDr Claire Smith, Consultant Radiologist St James University Hospital Leeds
Dr Claire Smith, Consultant Radiologist St James University Hospital Leeds Imaging in jaundice and 2ww pathway Image protocol Staging Limitations Pancreatic cancer 1.2.4 Refer people using a suspected
More informationManagement of Pancreatic Fistulae
Management of Pancreatic Fistulae Jose Ramos University of the Witwatersrand Donald Gordon Medical Centre Fistula definition A Fistula is a permanent abnormal passageway between two organs (epithelial
More informationSurface Anatomy. Location Shape Weight Role of Five Surfaces Borders Fissures Lobes Peritoneal Lig
The Liver Functions Bile production and secretion Detoxification Storage of glycogen Protein synthesis Production of heparin and bile pigments Erythropoiesis (in fetus) Surface Anatomy Location Shape Weight
More informationResident Teaching Conference 10/16/09 Rondi Kauffmann Resident presenter William Nealon Faculty presenter
Resident Teaching Conference 10/16/09 Rondi Kauffmann Resident presenter William Nealon Faculty presenter KC 59 year old male Referred to Surgery clinic for incidentally discovered 5cm x 3cm pancreatic
More informationImaging in gastric cancer
Imaging in gastric cancer Gastric cancer remains a deadly disease because of late diagnosis. Adenocarcinoma represents 90% of malignant tumors. Diagnosis is based on endoscopic examination with biopsies.
More informationEFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY Building a European Ultrasound Community
MINIMUM TRAINING REQUIREMENTS FOR THE PRACTICE OF MEDICAL ULTRASOUND IN EUROPE Appendix 9: Endoscopic Ultrasound in Gastroenterology This curriculum is intended for clinicians who perform endoscopic ultrasonography
More informationAccessory Glands of Digestive System
Accessory Glands of Digestive System The liver The liver is soft and pliable and occupies the upper part of the abdominal cavity just beneath the diaphragm. The greater part of the liver is situated under
More informationCollecting Cancer Data: Pancreas
Collecting Cancer Data: Pancreas NAACCR 2011 2012 Webinar Series 1/5/2012 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching this
More information1 Right & left Hepatic ducts Gastric Impression of spleen
Pancreatic Model 1 Right & left Hepatic ducts 14 Gastric Impression of spleen 2 Common hepatic duct 15 Renal Impression of spleen 3 Cystic Duct 16 Colic Impression of spleen 4 Common Bile Duct 17 Splenic
More informationAnatomy of the liver and pancreas
Anatomy of the liver and pancreas Prof. Abdulameer Al-Nuaimi E-mail: a.al-nuaimi@sheffield.ac.uk abdulameerh@yahoo.com Liver Aorta Pulm. Trunk Rt. At, Duct. Art. Lt. Ven. Rt. Ven. Internal Posterior
More informationGeneral'Surgery'Service'
General'Surgery'Service' Patient Care Goals and Objectives 1)! Stomach/Duodenum and Bariatric 2)! Interpret the results of clinical evaluations (history, physical examination) performed on patients being
More informationAnatomy of the biliary tract
Harvard-MIT Division of Health Sciences and Technology HST.121: Gastroenterology, Fall 2005 Instructors: Dr. Jonathan Glickman Anatomy of the biliary tract Figure removed due to copyright reasons. Biliary
More informationImaging of common diseases of hepatobiliary and GI system
Imaging of common diseases of hepatobiliary and GI system Natthaporn Tanpowpong, M.D. Diagnostic radiology Faculty of Medicine, Chulalongkorn University Normal plain radiograph A = Common bile duct
More information- Tamara Wahbeh. - Fareed Khdair. 0 P a g e
-1 - Tamara Wahbeh - - Fareed Khdair 0 P a g e GI Embryology Note: I included everything in the records and slides; anything in the slide not included in this sheet was not mentioned by the doctor during
More informationChronic Idiopathic Myelofibrosis (CIMF)
Chronic Idiopathic Myelofibrosis (CIMF) CIMF Synonyms Agnogenic myeloid metaplasia Myelosclerosis with myeloid metaplasia Chronic granulocytic-megakaryocytic myelosis CIMF Megakaryocytic proliferation
More informationSiddharth Gosavi, Vydehi Institute of Medical Sciences & Research Centre, India Under the guidance of Gillian Lieberman, MD
Under the guidance of Gillian Lieberman, MD March 2016 RADIOLOGICAL HALLMARKS OF NECROTIZING PANCREATITIS Siddharth Gosavi, Vydehi Institute of Medical Sciences & Research Centre, India Under the guidance
More informationTaking The Fear Out of Abnormal CBC s Problems of Production, Destruction or loss
Taking The Fear Out of Abnormal CBC s Problems of Production, Destruction or loss Joanne Eddington, MN, FNP, AOCN Providence Oncology and Hematology Care Clinic - Eastside Blood Cell Abnormalities Abnormalities
More informationDr. Attila Zalatnai PATHOLOGY OF THE BILIARY TRACT AND PANCREAS
Dr. Attila Zalatnai PATHOLOGY OF THE BILIARY TRACT AND PANCREAS MAIN COMPONENST OF THE BILE bile acid salts bilirubin (conjugated, direct!) cholesterol phospholipids fatty acids mucoproteins calcium water
More informationABDOMEN - GI. Duodenum
TALA SALEH ABDOMEN - GI Duodenum - Notice the shape of the duodenum, it looks like capital G shape tube which extends from the pyloroduodenal junction to the duodenojejunal junction. - It is 10 inches
More informationImaging Guided Biopsy. Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer
Imaging Guided Biopsy Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer Objective By the End of this lessons you should : Define what biopsy Justify Aim to perform biopsy
More informationAssistant Professor: Dr.Samer Al-Sawalhi (M.R.C.S.I)(M.D)
Assistant Professor: Dr.Samer Al-Sawalhi (M.R.C.S.I)(M.D) The incidence of pancreatic ca is 10:100000 population per year *The disease is a disease of ageing. Male=Female *Approximately 80-90%
More informationManagement of Acute Pancreatitis and its Complications Aspirus Grand Rounds June 6, 2017 Eric A. Johnson MD
Management of Acute Pancreatitis and its Complications Aspirus Grand Rounds June 6, 2017 Eric A. Johnson MD Disclosure: None In accordance with the Standards of the Wisconsin Medical Society, all those
More informationTools of the Gastroenterologist: Introduction to GI Endoscopy
Tools of the Gastroenterologist: Introduction to GI Endoscopy Objectives Endoscopy Upper endoscopy Colonoscopy Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic ultrasound (EUS) Endoscopic
More informationReticuloendothelial System (RES) & Spleen Dr. Nervana Bayoumy
Haematology Lectures Reticuloendothelial System (RES) & Spleen Dr. Nervana Bayoumy 1 Objectives 1. Define the term Reticuloendothelial system (RES). 2. Describe the cellular components of RES. 3. Describe
More informationDairion Gatot, Soegiarto Ganie, Savita Handayani. Divisi Hematologi & Onkologi Medik Departemen Ilmu Penyakit Dalam FK-USU/RS H.Adam Malik Medan 2009
HAEMOLYTIC ANAEMIA Dairion Gatot, Soegiarto Ganie, Savita Handayani. Divisi Hematologi & Onkologi Medik Departemen Ilmu Penyakit Dalam FK-USU/RS H.Adam Malik Medan 2009 WHEN BY THEN Hb 9 g% transfusion
More informationThe pathology of pancreas
5. Practice The pathology of pancreas 2017/2018. 2nd semester MACROSCOPY- MICROSCOPY THE STRUCTURE OF PANCREAS Exocrine: 80-85% Enzymes in the zymogenic granules of acinar cells: trypsin, chymotrypsin,
More informationAnemia (3).ms4.25.Oct.15 Hemolytic Anemia. Abdallah Abbadi
Anemia (3).ms4.25.Oct.15 Hemolytic Anemia Abdallah Abbadi Case 3 24 yr old female presented with anemia syndrome and jaundice. She was found to have splenomegaly. Hb 8, wbc 12k, Plt 212k, retics 12%, LDH
More informationCase 1. Intro to Gallbladder & Pancreas Pathology. Case 1 DIAGNOSIS??? Acute Cholecystitis. Acute Cholecystitis. Helen Remotti M.D.
Cholecystitis acute chronic Gallbladder tumors Adenomyoma (benign) Adenocarcinoma Pancreatitis acute chronic Pancreatic tumors Intro to Gallbladder & Pancreas Pathology Helen Remotti M.D. Case 1 70 year
More informationThe Fellowship Council And The American Hepato-Pancreatico Biliary Association
The Fellowship Council And The American Hepato-Pancreatico Biliary Association Advanced GI Surgery Curriculum for Hepato-Pancreatic & Biliary Surgery Fellowship 1. Introduction The purpose of Fellowship
More informationAbdomen Sonography Examination Content Outline
Abdomen Sonography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 Anatomy, Perfusion, and Function Pathology, Vascular Abnormalities, Trauma, and Postoperative Anatomy
More informationDiseases of liver. Dr. Mohamed. A. Mahdi 4/2/2019. Mob:
Diseases of liver Dr. Mohamed. A. Mahdi Mob: 0123002800 4/2/2019 Cirrhosis Cirrhosis is a complication of many liver disease. Permanent scarring of the liver. A late-stage liver disease. The inflammation
More informationIndex (SIRS), 158, 173
Index A Acute pancreatitis surgery abdominal compartment syndrome, 188 adjuvant treatment, 194 anterior approach, 175 antibiotic prophylaxis, 166 167, 197 Atlanta classification, 181 classification of
More informationImaging of liver and pancreas
Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma
More informationThe peritoneum. Prof. Oluwadiya KS, MBBS, FMCS(Orthop) Website:
The peritoneum Prof. Oluwadiya KS, MBBS, FMCS(Orthop) Website: http://oluwadiya.com The peritoneum Serous membrane that lines the abdominopelvic cavity and invests the viscera The largest serous membrane
More informationAfternoon Session Cases
Afternoon Session Cases Case 1 19 year old woman Presented with abdominal pain to community hospital Mild incr WBC a14, 000, Hg normal, lipase 100 (normal to 75) US 5.2 x 3.7 x 4 cm mass in porta hepatis
More information