文档介绍：胰腺疾病
胰腺疾病英文
解剖生理概要
解剖
头，颈，体，尾，钩突。
主胰管 (duct of Wirsung)
副胰管 (duct of Santorini)
胰腺分泌
外分泌Exocrine
内分泌Endocrine od gas analysis
Imunolipase
ALT and AST (gallstone pancreatitis )
胰腺疾病英文
Imaging finding
X-ray
Dilated loop of small bowel (sentinel loop)
Abrupt cessation of gas in the distal transverse colon (colon cutoff sign)
Radioopaque densities (biliary calculi)
Left-sided pleural effusion
B-US: pancreatic edema, ascites----
CT: Important
急性胰腺炎
胰腺疾病英文
•CT is the best diagnostic test for the diagnosis of acute pancreatitis.
•Contrast-enhanced CT is excellent for diagnosis of pancreatic necrosis
有力武器
胰腺疾病英文
急性胰腺炎
Assessment of severity of acute pancreatitis
Ranson's criteria
On Admission Within 48 Hours
Age > 55 years Hematocrit decrease by >10%
WBC > 16,000 /mm³ Urea nitrogen increase > 5 mg/dl
LDH > 350 IU/L Serum calcium < mmol/l
Glucose > Arterial PO² < 8KPa(60 mm Hg)
AST > 250 IU/L Base deficit > 4 mEq/L 
Estimated fluid sequestration > 6 L
胰腺疾病英文
急性胰腺炎
Glasgow Criteria
Within 48 Hours
Age > 55
WBC > 15,000 /mm³
LDH > 600 IU/L
Glucose > 180 mg/dl
Albumin < g/dl
Calcium < 8 mg/dl Urea > 45 mg/dl
Arterial PaO2 < 60 mm Hg
胰腺疾病英文
急性胰腺炎
APACHE III criteria
Temperature • BUN
Mean blood pressure • Leukocytes
Serum Creatinine • Hematocrit
Heart rate • Albumin
Respiratory rate • Bilirubin
Oxygenation
Arterial pH
Serum sodium and potassium
Serum glucose
>8 Scores ----SAP
胰腺疾病英文
Diagnosis and differential Diagnosis
Acute edematous pancreatitis and acute hemorrhagic necrotizing pancreatitis
Other diseases
Acute appendtitis
Ileus
Perforated gastroduodenal ulcer
Biliary disease
Ruptured hepatoma
急性胰腺炎