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G)

en<Mem* a/ V
—The pane reoue dleueJapS -Fronn 1 2 bezels
1_ ViM'al hud (_ hepa-Fc 4<ver +i'cularn) -

X- -OdfSkCA.1 b<xd dud<dcAcA.l ‘-h'JC.f'b C<A|U frQ J O/JA


< l^^ncr.
* CflA^eniToJ otumvibes - -
(SX^hnalar pa A crease i — r S^HCrca Ur\cdU\^ 2?^ path ck^ Aervirn

t^h/ch —> bile spuned Jo.Q\i KA$> (\V belouj ampulla)


- P/ftj'A X" eevy _i» cjou-b/e.
louLUe A^n . . ,, .
@- 6ckp»’c parvcr^aSe : — '—', clv/odten^n-Mectelj . . .eab'u*<VcUl^
(\h rhjm«cK

9
(^Physiology :JJ

• The pancrease IS a mixed e.x.ocv»7xe Sf £ nJ ocr .we afjan-

*£xocrin< funx.:- h&j


- P4ACffa.-bc act’ni Secrete f-2. /.‘dre-S oF alK^I/ae - r<ch j-Luce/c(<^

- CA^jme-S condouA lipaje / amjIaJe ? prohcolyKc drypJx A ojen

GY\A ch y mo'fyjj pli.

*«CCK (fcKole^pFbk»'n'n) jecr^led ■fnifh d xcd e ACI I maa^Je—> secfe.'hQ^ an eiv^rne - / Teh .Sec red'd/?

prum pa.ncreak <$,

• Secfe4i'a Rom duo de Au.I mu&iSa—■> a.lkaCfl< CHC03) T»C\ ^ecfe-d^h »


—» JccfeRtfA iAk'h-lcd by £>nvp<vhheFh shXvJq 4i<5)n , S^<nado*4a.RA ^^lua^Go
c Secceh'^ 3 Rm bladed hj fkifa. jympT va^as) sRnv

*■ Endocrine fax \.
-4-SecCele GjkLtajtfrt *
• Alph<x Cells - —(‘ASkAliA'* ]
• Bela cells - —> s'o m&'A s -P\-B 'A - > tkeie ce/ls
belong -to APOD j<?ne5-
- De Ila celU -
- G - cells-- ’ (^CLSR.'A
C G ’ ce. 11 s woh -Found AorfiruOy «f\ p^nc/eaje bud 'Z.E SJ/vdlr&me.
♦ Ana-IOIAM

i/escT ion :
- PancfeaS i\
dn - el^Qja+eJ glaaol , (.’es uA pash- abdo<n«nql UeJl|
CK Pencl./y
♦ Head ;. Li’ei frim dkioJeakiAD 4-o h»tam o(- sp|een7 consist af : c©n<A7Xj-^ o?

in duockefXQm , hai/uy purl behoof


S*f>*h6r nxejealr.c vessels GfiJleJ Onc/nahe Process.

. rek4-ec( /We/Vof^ iVC a ^beVn.4 ke<wQ


ctJD »Aj«de ke»-d.
p^rhevx bekje_»€n He^A ^-bod^ r
• Neck «» Aarfoui
L/eS »*n cP ■PC>GVA4<6\V ctf- p*rA»J vein.
* Bo 4 j ; • trr* nj I a r , crouiflj? /n?ol line. .

* Lies \X €nsr\4~ *F“ splenic vein ^splenic arhey runs*


IOOJJJ
above
•>1
hi lum °F Spleen relief a U\n© fen©il (L*j.
• TOJL :. - « A'bectde 4

-P&ncfeai has 2. d«cts


?•
i._ -^a‘A Pancrec^’c c£^cV (Duel o-f MJ ir j q nj-f) ; CBD "U -for/v\
Xo»n»<y
Vxcox.4 «
O./Y'P’AUCS, vocVer , Corses •fr-iiV' 4T3»t i X
ixnCi Xs^hc.
(2)- Accessory Pane. ctac.1 (Oacl p/bceSr cspenl
San+ofiA’i) : fram
o
Ach Ckboue (ffAKi.-Y^I J
P 2nd P*rh dp-« rrspusM <$■ (~

ho sja'tar

bfancUeJ o(* Spleryc Qrh<y

d^d<aoJ and punCfOvh CA> dtexa JLg/\x’\J


ar4er.es.
- Ue«hxs> (hh& cures fson.cL'y Veins P^rbal

•*

*Qh P<AAC/‘e.c<h 0© Spleenic LN


LN Mo,A
®- Super‘&r me serxhnX. p^Ur.^ - pancr.
d^ct
LN-

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farxc. cU<eclen*A Ek
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/•» Ka3'| 4< taue'i
-* Aertiolo
(TA 8*)^
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Alcakol retake. ( as*7.).


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Scorp.on tales . p<mve^Kc G*C^AOAUC Thiazidediuretic

E r«WAoiogy
— Glos kuctan of pG\ncr^b'G ^Weviu-TV) d-U.G'i "to
p a AtfeuJ e -> Qc4</o<ta paacn?«\ta (_"Trypi?rxo^en)
<xu4ocbjcs4»<?n of panGC£(\Se •

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Ga kfum
Jb<A.p _* h J p o C-AI c a fegv* G\ .
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a.ca,-ta Vkaejn o rr kojj K_ //

acuta- ftecyta’zMj **

^ C»mpl»coions :7 O/D
• Acuta
General - Aypovotatnic stack , DIC
- pa-Talyta deus - acuta
pep KG u.ker-
- acixta
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CkotaujS-RliJ <5»-
- ftalb or/<4rx F<6 lure
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- Le«k.\j AAft •~ax<<ta_ /4I
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———-
VMular occU4$i<D>
K loii of pl<am.& ptn
CAA© pet'tan.e*( cxxu.-kf & Kmin 4, gt>.
pM brf^oun pfOctaf
®
*Cli*AiCal Pic+are ••
—d(sevef€^:-AAa«‘n £«X all cajej)
• Symptoms abJdrrvAal pa»n
j preceded bj ke^vy me^tl or qltkj
rxcKa'U- 4o back

— Vo ml -Knj &< YeActvA^ uf< prom«Aar\V Peaiufej , hicCoUjk.


• rna-y ev/dence e>£ hypo ^(eintC shock
- H /o kke <*

s. „ General —i
jcuAAcL’ce <&C ojanoSU <* loX.(p«nc. oe^tna)
• pa m
• m» lol r«.(.»cject by lean.nj -foreword .
• G^ray
4-ender r«jicZ <^pper abJanxen^

Turner sijrx: cL'iCokfaVsh of Lorn i


. Call en^ '*

oUjco\ofeck'6K ar»uAc| umbiL’ijJ J*k-


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er < t^necA^

& Seram a.nr\5y|aJe elcJaYed > 1OOQ iO/dL (N^IC t in -


("no! spcufVc. ; fef/©C<K+€d pej^-h'c ulcer-
- /\ cboleoji-Bfu neuer lO/dl
- rt\y<>(.«rcl»‘al »'n (-ar^KSTh
- •‘ni* obii ra.L-|-»'^r>

@
Serum l»pase r$ ufKj la se^ «
€lesja^ed £cnx>fe ipeufrt -VVxan
AS6j , W&C , J/e/G , LPT. . — etc • (1 <-* . taka** . Xoj) z 6-C^ . cfK

- /AX&. (abcGrruAal x-fcvj) • Sen4irAel loop : d»ln.fej ^ejMeA-i of 5Mali CnAeitn adjxcervV

d » Colon Cai-off
A-o pantA (jocal Ileus)

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Collapsed deJcftndry-S/ULJOUJ •
& • AbiCA-4 fl fcCU
.‘A 2cX .
• pleural eWudi'6n

(jjH USS (ulMkSouAcO Bf CT JCan


pani/^j dcicuU fapetiVeJy
AerckeJ ,

Prognosis -- cKurcktb

P^rUViy rate. onfall <*s a boat io'/. , uj»4k\ <xct*Ac hepiQfrhucpc


panx/ecx-h-hj ^> 3b'/. ^^A/en So’/ »’n netfb-|i^?nj one
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7- MwHof £ J'fexl/X'U. pV [ CA.fKe.Aer , 666, , SJ>,....epQ

3- C/^CP ^k.f4er pF 5-4-<AIO^^ ren\oc'€_


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• on adftii si'i on - aje >55 yf* .uJfiC >l6Xlo’/l- GiHSC^CJ SCcde_ ^eTn 4^1^ • age
• Glucose > (o mmol/c.
>• £“5T grJ-
• LDH > 7oo m/L
• AST > ZSO iU/Z.
• 0lqco5e /o (too ny/Jd)
• Ufeg t > U mmol/L • LOH >
• Co.'*' 2 m mo / L • AST/ALT > ^oo
W-Wn HS • PgOt <■ 8 Kft* (OomMtj) 9 U/-e,<x 7> I b
4> b<UQ defied < 1/
9 Ca <2. a rk<2z "C 3
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• Albu*A»A 3J^-

- Tk«c /none Cf/terAx , pke greater 4ke. m^rhA\;Vy.


- Sevum cxrAK|\aje_ 8( L’^qje do A°f- Correlate t-”’4k Seuerf
of paitcreq+i'-Ax
CHRONIC PANCREATITIS

Pe£i<\tVion :- <’AurcX’n
-I-S Q con-knu/ng »All«imnu\}or^ disease ch.afacVer»r^ecl lo^
irreversible faAdonal 8< anc\4omica.l ccb/mr/nod.'li'es P«accdGVS£J.
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[fV u,CouL —G*M/cA|ed i-f pain is •uncaivWlecQ

• €K.Cp iiuerK*v> s-tan^- <A Vke <Amd . <• Vi«r<.h'H

• to AJ i K4<r\aJ pd/tf.re<KKa)- jcjan^-krhj *apemV6Vi $| du»ke

• Park'*! pa/K/ecAec-loiw/J £ pruyfoioj or


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suisx>|doau sifvaAouBj
lini ICTU
«•
-Abeta/ynkal Pain Caused by p^pfrc. uJcenvV<m itf /nay b leej fer-fon<4e
- +ht DK of GiavF'n^/nq fs
soAp e c-Fe <J by c-
1- Ulcers res/stanl
2- recur/end ulcers , ■to -Freoutmervf. e-

K^ren^s o-fSi •Fes .


u.naSuc\l
3 - Mulkpfe ulcers »'n
- Dla/lVxo^a «’K
U\»vJ of Case V because of fy (^as-hr/n
* ^ujperacd./ ■€*\5yAneJ. (Gasfrinortla £\j
♦ Csj CLSFY 1 n—4. @T pan creole
—^©^fnUa}e (h-fes-Knal

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— Upper GIT endoscopy <$- ± loan-a An me«x( -sh*vjj 4ke ulcers.
FUYXCVSV) 4evQ —esfmde Serum gaVk-A [ N - <|50 ng / LQ
IA /TJOSl OstSeS df geiS 4f/A0m.U. "/*5oo AJ/L-
— Loc<klze fbe fun^r—CT scan, Seje&lii/e anny .o y rovp Ky.

FTreatment :*
I o C^(/ZA4IV>
— Zdeal "Ht fs eKCSiSA of jumouir (^only 2.0 X reSecfable —4<Mb’^e t pooz } ,
— USUOLI 4R - To4ul 3Qrfre ctomy Q abolkh AU4 jecre'Kcr?).,
Less effecMe ttt /s pn>lonye4 •*<vten&vfc F^r by ovneprrzale.

♦ICAR.CINOMA ):

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»CUCAI picture :•
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-Lab ©rectory LFT , jau^d'et •’rv^^x^cv^vsta,


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