acute pancreatitis by simmedic UKM

1. Simmedic UKM ACUTE PANCREATITIS

6. Pathogenesis of acute pancreatitis Interstitial oedema Impaired blood flow Ischaemia Acinar cell injury Interstitial inflammation oedema Gallstone Chronic alcoholism Release of intracellular proenzymes and lysosomal hydrolases Activation of enzymes ACTIVATED ENZYMES Delivery of proenzymes to lysosomal compartment Intracellular activation of enzymes Proteolysis (proteases ) Fat necrosis (lipase, phospholipase) Haemorrhage (elastase ) Alcohol, drugs trauma, ischaemia, viruses Metabolic injury (experimental) Alcohol, duct obstruction DUCT OBSTRUCTION ACINAR CELL INJURY DEFECTIVE INTRACELLULAR TRANSPORT

8. pathogenesis

9. progression

10. Acute Pancreatitis; Haemorrhage and necrosis

11. Acute pancreatitis

12. Normal pancreas Acute pancreatitis

13. Saponification of fat

14. Acute Pancreatitis A surgical specimen of the transverse colon and greater omentum shows extensive fat necrosis. Note bright yellow foci. The mesenteric fat has been completely digested away so as to reveal the isolated blood vessels.

15. Cullen sign – discolouration around umbilicus

16. Cullen sign

17. Grey-Turner sign- discolouration in the flanks

24. Pseudocyst of pancreas

25. Acute pancreatitis. The pancreas is enlarged (blue arrow) with indistinct and shaggy margins. There is peripancreatic fluid ( red arrow) and extensive peripancreatic infiltration of the surrounding fat ( black arrow).

26. 74-year-old man with acute pancreatitis. Axial contrast-enhanced CT scan shows one fluid collection in anterior pararenal space and minimal necrosis.

28. Thank you..