The pancreas is a 6 to 10 inch long oblong and flat organ present at the back of the abdomen and behind the stomach. It is responsible for exocrine and endocrine functions. It contains exocrine glands that produce enzymes and hormones. These enzymes and hormones are responsible for digestion and break down of foods. As an endocrine function, it helps release juices directly into the blood stream.
Diagnosis and evaluation
The evaluation of the pancreas proves rather difficult due to its location. The disorder to the pancreas can be determined through blood tests, radiographic tests, CAT scans, endoscopic ultrasound and magnetic resonance imaging. The tests conducted to evaluate pancreatic ducts are ERCP and MRCP. In some complex cases, surgical exploration can be the only way to confirm the disorder within the organ.
There are many disorders of the pancreas with each of them having their own prognosis. However, some of the most common disorders of the pancreas are outlined below.
Pancreatitis is inflammation of the pancreas. There is a sudden attack and painful swelling associated with severe upper abdominal pain lasting for many days. Gallstones are one of the most common causes of acute pancreatitis. The symptoms can be inclusive of diarrhea, nausea and vomiting, fever, bloating and tachycardia. Other causes can also be hormonal abnormalities, high lipid levels, infections, trauma, hereditary conditions and electrolyte abnormalities. At times acute pancreatitis can be life threatening requiring ICU management and surgery.
Pancreatitis can also be an inherited disease and are usually evident as acute recurrent attacks at a very young age. The most commonly inherited disorder is cystic fibrosis. Genetic testing is the best way to evaluate this disorder. Hereditary pancreatitis is a progressive disease and patients are at a risk of permanent incapacitations. Symptoms are associated with diarrhea, malnutrition, chronic pain and diabetes. Enzyme replacements and pain controls seem to be the best treatment plans for this disease.
Sphincter of Oddi Dysfunction
A sphincter is a muscle that controls the opening and closing. The sphincter of oddi (SO) is a muscular valve which regulates the flow of pancreatic juices and biliary juices into the small intestine. It also averts reflux of bowel contents into the pancreatic and bile ducts. It also helps diverting the hepatic bile into the gall bladder. The dysfunction of the sphincter is more often associated with either the pancreas or the bile duct. One of the major symptoms of SO dysfunction is abdominal pain with nausea and vomiting and corresponding back and shoulder pain. Patients can also experience jaundice, fever and chills in some cases.
Pancreatic cancer can occur when a cell in the pancreas is damaged and malignant. This malignant cell grows out of control and can be the primary causes of adenocarcinoma of the pancreas, adenosquamous carcinoma and squamous cell carcinoma. Where adenosquamous carcinoma and squamous cell carcinoma are rare, adenocarcinoma of the pancreas is frequent and occurs in the lining of the pancreatic duct. The predominant risk factors are associated with age, heavy smoking, obesity and family history. This cancer is fairly common and presents with jaundice. A Whipple’s operation is the treatment of choice and in patients not fit for surgery , Endoscopic stenting of the common bile duct is done.