Pseudocyst Health Dictionary

Diabetes See DIABETES MELLITUS.

Pancreatic cancer The incidence of pancreatic cancer is rising: around 7,000 cases are now diagnosed annually in the UK, accounting for 1–2 per cent of all malignancies. There is an established association with heavy cigarette-smoking, and the cancer is twice as common in patients with diabetes mellitus as compared with the general population. Cancer of the pancreas is hard to diagnose; by the time symptoms occur the tumour may be di?cult to treat surgically – with PALLIATIVE bypass surgery the only procedure.

Chronic pancreatitis may be painless; it leads to pancreatic failure causing MALABSORPTION SYNDROME and diabetes mellitus, and the pancreas becomes calci?ed with shadowing on X-RAYS. The malabsorption is treated by a low-fat diet with pancreatic enzyme supplements; the diabetes with insulin; and pain is treated appropriately. Surgery may be required.

Acute pancreatitis An uncommon disease of the pancreas which may start gradually or suddenly, usually accompanied by severe abdominal pain which often radiates through to the back. Biliary tract disease and alcohol account for 80 per cent of patients admitted with acute pancreatitis, while other causes include drugs (see AZATHIOPRINE and DIURETICS) and infections such as MUMPS. Patients are acutely ill with TACHYCARDIA, fever and low blood pressure; many go into SHOCK. The condition may be mistaken for a perforated PEPTIC ULCER, except that in acute pancreatitis the blood concentration of AMYLASE is raised. The main complication is the formation of a PSEUDOCYST. Treatment includes intravenous feeding, ANTICHOLINERGIC drugs and ANALGESICS. Regular measurements of blood GLUCOSE, CALCIUM, amylase and blood gases are required. Abdominal ULTRASOUND may identify gall-stones (see under GALL-BLADDER, DISEASES OF). If the patient deteriorates, he or she should be admitted for intensive care as haemorrhagic pancreatic necrosis may be developing. LAPAROTOMY and DEBRIDEMENT may be called for. Mortality is 5–10%.... pancreas, disorders of

n. 1. an abnormal sac or closed cavity lined with *epithelium and filled with liquid or semisolid matter. There are many varieties of cysts occurring in different parts of the body. Retention cysts arise when the outlet of a glandular duct is blocked, as in *sebaceous cysts. Some cysts are congenital, due to abnormal embryonic development; for example, *dermoid cysts. Others are tumours containing cells that secrete mucus or other substances, and another type of cyst is formed by parasites in the body (see hydatid). Cysts may occur in the jaws: a periapical cyst occurs at the apex of a tooth, a dentigerous cyst occurs around the crown of an unerupted tooth, and an eruption cyst forms over an erupting tooth. See also fimbrial cyst; ovarian cyst; pseudocyst. 2. a dormant stage produced during the life cycle of certain protozoan parasites of the alimentary canal, including *Giardia and *Entamoeba. Cysts, passed out in the faeces, have tough outer coats that protect the parasites from unfavourable conditions. The parasites emerge from their cysts when they are eaten by a new host. 3. a structure formed by and surrounding the larvae of certain parasitic worms.... cyst

the fusion of endoscopy with ultrasonography. An ultrasound probe is incorporated into the endoscope in order to deliver highly detailed images from within the body. Endoscopic ultrasound is used predominantly by gastroenterologists, to assess internal structures or organs within the upper gastrointestinal tract, or by respiratory physicians in the assessment of bronchial disease. It may be used for diagnostic purposes, to accurately stage a confirmed diagnosis of cancer or to obtain tissue samples using fine-needle aspiration. Therapeutic indications include drainage of a pancreatic *pseudocyst, the common bile duct, or the pancreatic duct, and coeliac plexus neurolysis, a technique used to deliver pain relief in cases of intractable abdominal pain, usually resulting from chronic pancreatitis.... endoscopic ultrasound

n. inflammation of the pancreas. Acute pancreatitis is a sudden illness in which the patient experiences severe abdominal pain that radiates to the back. In severe cases, there is rapid deterioration with shock. Serum amylase levels are high. Its cause is not always discovered, but it may be associated with gallstones, alcoholism, drugs, infection, autoimmune disease, or recent interventions (such as ERCP). Complications include the formation of *pseudocysts, abscesses, necrosis (necrotizing pancreatitis), and haemorrhage (haemorrhagic pancreatitis). Treatment consists of restricting oral intake, intravenous hydration, and antibiotics if infected necrosis is present. In severe cases, *pancreatectomy may be required to remove necrosed tissue. Relapsing pancreatitis, in which the above symptoms are recurrent and less severe, may be associated with gallstones or alcoholism; prevention is by removal of gallstones and avoidance of alcohol and fat. Chronic pancreatitis may produce symptoms similar to relapsing pancreatitis or may be painless; it can lead to endocrine failure causing *malabsorption and *diabetes mellitus. The pancreas often becomes calcified, producing visible shadowing on X-rays. Autoimmune pancreatitis is a recently described condition in which an autoimmune process leads to inflammation and swelling of the pancreas. Although abdominal pain is minimal or absent, jaundice is usually present. Radiologically it is characterized by diffuse ‘sausage-shaped’ enlargement of the pancreas and narrowing of the main pancreatic duct. The presence of raised serum IgG4 is a serological marker. Treatment involves immunosuppressant agents (e.g. corticosteroids or azathioprine). Autoimmune pancreatitis is associated with other autoimmune disorders.... pancreatitis