أبو يوسف
03-09-2007, 09:27 AM
The pancreas is subject to many disorders; however, several occur much more frequently than others. These includediabetes, pancreatitis, pancreatic cancer and pseudocysts of the pancreas.
Diabetes
Diabetes is a metabolic disorder found in three forms— type 1, type 2 and gestational. Type 1 is an autoimmune disease; the immunesystem destroys the pancreas’ insulin-producing beta cells, reducing oreliminating the pancreas’ ability to produce insulin. Type 1 diabetes patientsmust take daily insulin supplements to sustain life.1 Symptoms typically developquickly and include increased thirst and urination, chronic hunger, weight loss,blurred vision and fatigue. Type 2 diabetes is the most common, found in 90percent to 95 percent of diabetes sufferers. It is associated with older age,obesity, family history, previous gestational diabetes, physical inactivity andethnicity. Approximately 80 percent of type 2 patients are overweight. It ismore frequently being diagnosed in children and adolescents as America’s youthbecomes more inactive and eats less healthy meals. Symptoms may develop slowlyand can include fatigue, nausea, frequent urination, unusual thirst, weightloss, blurred vision, frequent infections and slow wound healing. Gestationaldiabetes occurs only in pregnancy. It is found more frequently inAfrican-Americans, Native Americans, Hispanic Americans and in women with afamily history of diabetes. Women who develop gestational diabetes have a 20percent to 50 percent chance of developing type 2 diabetes within five to 10years. Diagnosis is made via a fasting plasma glucose test and is most reliableif done in the morning. But a diagnosis may be made after any of three tests,with confirmation from a second positive test on a different day. These includea random plasma glucose value of 200 mg/dL or more, with symptoms of diabetes; aplasma glucose value of 126 mg/dL or more after an eight-hour fast; or an oralglucose tolerance test plasma glucose value of 200 mg/dL or more in a bloodsample taken two hours after consuming 75 grams of glucose dissolved in water.This test measures plasma glucose at timed intervals over three hours. Treatmentinvolves healthy diet, physical activity and insulin for type 1 diabetics;healthy eating, physical activity and blood glucose testing are used to managetype 2. Some of these patients require insulin supplementation.
Pancreatitis
Pancreatitis— the inflammation and autodigestion of the pancreas — can be either acuteor chronic. In autodigestion, the pancreas is destroyed by its own enzymes,which cause inflammation. Acute pancreatitis typically involves only a singleincidence, after which the pancreas will return to normal. Women are 1.5 timesmore likely to suffer acute pancreatitis due to gallstones, while men are sixtimes more likely than women to have acute pancreatitis due to alcoholism. Up to90 percent of affected patients recover with no complications.2
Chronic pancreatitis, however, involves permanent damage to the pancreas and pancreaticfunction and can lead to fibrosis. Alternately, it may resolve after severalattacks.
Pancreatis is most frequently caused by gallstones blocking thepancreatic duct or by alchol abuse, which can cause the small pancreaticductules to be blocked. Other causes include abdominal trauma or surgery,infections, kidney failure, lupus, cystic fibrosis, a tumor or a scorpion’svenomous sting.
Symptoms frequently associated with pancreatitis includeabdominal pain, possibly radiating to the back or chest, nausea or vomiting,rapid pulse, fever, upper abdominal swelling, ascites, lowered blood pressure ormild jaundice. Symptoms may be attributed to other maladies before beingidentified as associated with pancreatitis.
Pancreatitis is diagnosed usingabdominal X-ray, blood testing, ultrasound, ERCP, computer tomography scan orelectrocardiogram. It may be treated in several ways — hospitalization thatincludes observation and IV feeding, surgery, antibiotics, pain management, blood tests, bed rest, a nasogastric tube, fasting or theavoidance of alcohol. Chronic pancreatitis patients may also be given enzymesupplements to assist digestion, insulin, small high-protein meals andmedications to decrease gastric acid production. Pancreatitis leads to more than 100,000 hospital admissionseach year; approximately 2,000 of these patients die due to severe pancreatitis.3
Pancreatic Cancer
Pancreatic cancer — the fourth most common cancer in theU.S. — mainly occurs in people over the age of 60, and has the lowestfive-year survival rate of any cancer.4 Adenocarcinoma, the most common type ofpancreatic cancer, occurs in the lining of the pancreatic duct; cystadenocarcinoma and acinar cell carcinoma are more rare.However, benign tumors also grow within the pancreas; these include insulinoma — a tumor that secretes insulin,gastrinoma — which secretes higher-than-normal levels of gastrin, andglucagonoma — a tumor that secretes glucagon.
Pancreatic cancer has no known causes, but several risks,including diabetes, cigarette smoking and chronic pancreatitis. Symptoms mayinclude upper abdominal pain, poor appetite, jaundice, weight loss, indigestion,nausea or vomiting, diarrhea, fatigue, itching or enlarged abdominal organs. Diagnosis is made using ultrasound, computed tomography scan,magnetic resonance imaging, ERCP, percutaneous transhepatic cholangiography,pancreas biopsy or blood tests. Treatment may involve surgery, radiation therapyor chemotherapy, medication for pain or itching, oral enzymes preparations orinsulin treatment.
Pseudocysts of the Pancreas
Pseudocysts of the pancreas are abnormal collections of fluid,dead tissue, pancreatic enzymes and blood that can cause a painful pancreaticmass, according to the University of Virginia Health System.5 Symptoms may include abdominal pain, nausea, vomiting or poorappetite, weight loss, diarrhea, fever, jaundice, ascites or a detectable,tender mass in the abdomen. However, these symptoms may often be associated withother maladies.
Diagnosis is made via blood tests, chest X-ray, computedtomography scan, ultrasound or endoscopic retrograde cholangiopancreatography(ERCP). The patient may be treated with surgical drainage of the cyst or byclose monitoring using scans to identify growth or shrinkage of the cyst. Patients not undergoing treatment or monitoring may suffer arupture of the pseudocyst, which can cause severe pain, blood loss or infection
Diabetes
Diabetes is a metabolic disorder found in three forms— type 1, type 2 and gestational. Type 1 is an autoimmune disease; the immunesystem destroys the pancreas’ insulin-producing beta cells, reducing oreliminating the pancreas’ ability to produce insulin. Type 1 diabetes patientsmust take daily insulin supplements to sustain life.1 Symptoms typically developquickly and include increased thirst and urination, chronic hunger, weight loss,blurred vision and fatigue. Type 2 diabetes is the most common, found in 90percent to 95 percent of diabetes sufferers. It is associated with older age,obesity, family history, previous gestational diabetes, physical inactivity andethnicity. Approximately 80 percent of type 2 patients are overweight. It ismore frequently being diagnosed in children and adolescents as America’s youthbecomes more inactive and eats less healthy meals. Symptoms may develop slowlyand can include fatigue, nausea, frequent urination, unusual thirst, weightloss, blurred vision, frequent infections and slow wound healing. Gestationaldiabetes occurs only in pregnancy. It is found more frequently inAfrican-Americans, Native Americans, Hispanic Americans and in women with afamily history of diabetes. Women who develop gestational diabetes have a 20percent to 50 percent chance of developing type 2 diabetes within five to 10years. Diagnosis is made via a fasting plasma glucose test and is most reliableif done in the morning. But a diagnosis may be made after any of three tests,with confirmation from a second positive test on a different day. These includea random plasma glucose value of 200 mg/dL or more, with symptoms of diabetes; aplasma glucose value of 126 mg/dL or more after an eight-hour fast; or an oralglucose tolerance test plasma glucose value of 200 mg/dL or more in a bloodsample taken two hours after consuming 75 grams of glucose dissolved in water.This test measures plasma glucose at timed intervals over three hours. Treatmentinvolves healthy diet, physical activity and insulin for type 1 diabetics;healthy eating, physical activity and blood glucose testing are used to managetype 2. Some of these patients require insulin supplementation.
Pancreatitis
Pancreatitis— the inflammation and autodigestion of the pancreas — can be either acuteor chronic. In autodigestion, the pancreas is destroyed by its own enzymes,which cause inflammation. Acute pancreatitis typically involves only a singleincidence, after which the pancreas will return to normal. Women are 1.5 timesmore likely to suffer acute pancreatitis due to gallstones, while men are sixtimes more likely than women to have acute pancreatitis due to alcoholism. Up to90 percent of affected patients recover with no complications.2
Chronic pancreatitis, however, involves permanent damage to the pancreas and pancreaticfunction and can lead to fibrosis. Alternately, it may resolve after severalattacks.
Pancreatis is most frequently caused by gallstones blocking thepancreatic duct or by alchol abuse, which can cause the small pancreaticductules to be blocked. Other causes include abdominal trauma or surgery,infections, kidney failure, lupus, cystic fibrosis, a tumor or a scorpion’svenomous sting.
Symptoms frequently associated with pancreatitis includeabdominal pain, possibly radiating to the back or chest, nausea or vomiting,rapid pulse, fever, upper abdominal swelling, ascites, lowered blood pressure ormild jaundice. Symptoms may be attributed to other maladies before beingidentified as associated with pancreatitis.
Pancreatitis is diagnosed usingabdominal X-ray, blood testing, ultrasound, ERCP, computer tomography scan orelectrocardiogram. It may be treated in several ways — hospitalization thatincludes observation and IV feeding, surgery, antibiotics, pain management, blood tests, bed rest, a nasogastric tube, fasting or theavoidance of alcohol. Chronic pancreatitis patients may also be given enzymesupplements to assist digestion, insulin, small high-protein meals andmedications to decrease gastric acid production. Pancreatitis leads to more than 100,000 hospital admissionseach year; approximately 2,000 of these patients die due to severe pancreatitis.3
Pancreatic Cancer
Pancreatic cancer — the fourth most common cancer in theU.S. — mainly occurs in people over the age of 60, and has the lowestfive-year survival rate of any cancer.4 Adenocarcinoma, the most common type ofpancreatic cancer, occurs in the lining of the pancreatic duct; cystadenocarcinoma and acinar cell carcinoma are more rare.However, benign tumors also grow within the pancreas; these include insulinoma — a tumor that secretes insulin,gastrinoma — which secretes higher-than-normal levels of gastrin, andglucagonoma — a tumor that secretes glucagon.
Pancreatic cancer has no known causes, but several risks,including diabetes, cigarette smoking and chronic pancreatitis. Symptoms mayinclude upper abdominal pain, poor appetite, jaundice, weight loss, indigestion,nausea or vomiting, diarrhea, fatigue, itching or enlarged abdominal organs. Diagnosis is made using ultrasound, computed tomography scan,magnetic resonance imaging, ERCP, percutaneous transhepatic cholangiography,pancreas biopsy or blood tests. Treatment may involve surgery, radiation therapyor chemotherapy, medication for pain or itching, oral enzymes preparations orinsulin treatment.
Pseudocysts of the Pancreas
Pseudocysts of the pancreas are abnormal collections of fluid,dead tissue, pancreatic enzymes and blood that can cause a painful pancreaticmass, according to the University of Virginia Health System.5 Symptoms may include abdominal pain, nausea, vomiting or poorappetite, weight loss, diarrhea, fever, jaundice, ascites or a detectable,tender mass in the abdomen. However, these symptoms may often be associated withother maladies.
Diagnosis is made via blood tests, chest X-ray, computedtomography scan, ultrasound or endoscopic retrograde cholangiopancreatography(ERCP). The patient may be treated with surgical drainage of the cyst or byclose monitoring using scans to identify growth or shrinkage of the cyst. Patients not undergoing treatment or monitoring may suffer arupture of the pseudocyst, which can cause severe pain, blood loss or infection