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Surgery Pathophysiology - Chronic Pancreatitis 1189f426

True about Chronic pancreatitis are all except?

A
Damage to exocrine part with damage to endocrine part
B
Can leads to malignancy
C
Whipple's procedure can be done
D
Gall bladder stone is the most common cause
High-Yield Explanation
ANSWER: (D) Gall bladder stone is the most common causeREF: Schwartz 9th ed chapter 33, Sabiston 18th ed chapter 55Option (A): In chronic pancreatitis, acinar tissue loss and replacement by fibrosis is greater than the degree of loss of islet tissue, although islets are typically smaller than normal and may be isolated from their surrounding vascular network by the fibrosis. With progressive destruction of the gland, endocrine insufficiency commonly occurs. Frank diabetes is seen initially in about 20% of patients with chronic pancreatitis, and impaired glucose metabolism can be detected in up to 70% of patients.Option (B):Schwartz 9 th ed Table 33-13 Complications of Chronic PancreatitisIntrapancreatie complicationsExtrapancreatic complicationsPseudocystsDuodenal or gastric obstructionThrombosis of splenic veinAbscessPerforationErosion into visceral arteryInflammatory mass in head of pancreasBile duct stenosisPortal vein thrombosisDuodenal obstructionDuct strictures and/or stonesDuctal hypertension and dilatationPancreatic carcinomaPancreatic duct leak rvith ascites or fistulaPseudocyst extension beyond lesser sac into mediastinum, retroperitoneum, lateral pericolic spaces, pelvis, or adjacent visceraOption (C); Painful chronic pancreatitis can be treated with resection of the body and tail of the pancreas (distal pancreatectomy), resection of the head and uncinate process of the pancreas (Whipple procedure), subtotal pancreatectomy that spares a rim of pancreas along the inner curve of the duodenum, or total pancreatectomy.Option (D): Worldwide, alcohol consumption and abuse is associated with chronic pancreatitis in up to 70% of casesSchwartz 9th ed Table 33-6 Etiology of Chronic PancreatitisAlcohol, 70%Idiopathic (including tropical), 20%Other, 10%HereditaryHyperparathyroidismHypertriglyceridemiaAutoimmune pancreatitisObstruction (Tumor, Gallstone)TraumaPancreas di visum

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