The diagnosis as well as management of pancreatic cystic lesions is a general problem. Nearly 1% of the patients in the chief medical centers have been observed to have pancreatic cystic lesions on cross sectional imaging. It has also been observed that a quarter of all pancreas scanned in an autopsy series contain pancreatic cysts. Earlier, these cystic lesions were regarded benign but with increasing evidence made available from the cystic lesions, they are regarded as origin of pancreatic malignancies.


Information on asymptomatic neoplastic pancreatic cysts
The most vital medical tools that are used in the diagnosis and management of pancreatic cystic lesions include the endoscopic ultrasound and cross sectional imaging. These are used to distinguish non-mucinous cysts from mucinous cysts. The identification of pancreatic cysts creates a lot of anxiety for the clinicians as well as the patients related to the probable presence of a fatal tumor. The findings of a macro cystic lesion that enclose viscous fluid loaded in cea are helpful in the analysis of a mucinous lesion. 


The most common pancreatic cysts are the non-neoplastic inflammatory pseudo cysts, and they can be detected easily by imaging. The identification of pancreatic irregularity with probable association with malignant cells is a vital source of referral for the specialist. The set of guidelines that have been proposed for the management and diagnosis of patients with asymptomatic neoplastic pancreatic cysts are based specifically on the analysis of the quality of the data. It is also designed to address the most important and frequent clinical scenarios. The diagnostic suggestions are provided based on the clinical problem as well as the risk of malignancy.


Imperative guidelines to follow
To achieve accurate diagnosis of asymptomatic neoplastic pancreatic cysts is indeed a great challenge. It is all the more important to find the reproducible methods that can be used to stratify threat of cancer for the patients. The main guidelines include a two year screening interval of cysts that can be of any size as well as stopping observation after 5 years, in case there is no change. The new guidelines, for the most part, recommend surgery if more than one concerning feature is confirmed on the mri by use of endoscopic ultrasound. The new guidelines even suggest discontinuation of inspection after the surgery if no dysplasia or invasive cancer is identified. The guidelines have mainly been developed by use of grading of recomendations assessment, development and evaluation.

Diagnosis and Management of Asymptomatic Neoplastic Pancreatic Cysts

The pancreas is a gland located in the abdominal region that performs two main functions for the body: produces digestive juices and the hormone insulin which regulates the blood sugar levels. The part which produces the digestive juices is exocrine and the insulin-producing part is the endocrine portion. Pancreatic cancer, which is an uncontrolled growth of the pancreas cells, often starts in the exocrine portion and is known as the pancreatic adenocarcinoma. The one which develops in the endocrine portion is known as neuroendocrine cancer or islet cell tumors.

Risk factors
Though not clearly established, the following factors are believed to up the risk of pancreatic cancer.

Smoking
Family history
Prolonged uncontrolled diabetes
Pancreatic conditions like inherited pancreatitis
Chronic inflammation of the pancreas
Symptoms
A pancreatic condition is of insidious onset, and the exact period of onset cannot be determined. The symptoms also are nonspecific abdominal symptoms, which do not pinpoint the pancreas per se.

Jaundice, which includes yellowing of the skin and whites of the white. This is because the growth of the pancreas puts pressure on the liver and bile ducts, and so hampers bile flow.
Weight loss, which was unintended. This is due to a bloated feeling plus inability to digest the foods.
Severe pain, which can be difficult and may even require regular injections to control.
Fluctuating sugar levels, which is unexplained.
Onset of diabetes, which is associated with weight loss and jaundice.
Increased tendency for blood clots.
Loss of appetite.
Bowel obstruction due to blockage of the growing pancreas.
Diagnosis
The above symptoms could lead to a further investigation that includes a few important tests, like the following.

Blood tests
Insulin levels
CT scan
Ultrasound
MRI
Laparoscopy, both to look for the extent of the disease and to do a biopsy, which can be used for confirming the type of cancer
Percutaneous transhepatic cholangiography: A dye is injected into the pancreas to study the spread of the dye, which will also help identify the diseased portion.
Treatment
Pancreatic cancer is very aggressive, usually not detected early, and has a very poor prognosis. So, if there is a family history or one has a prolonged pancreatic condition, it is advisable to go for annual screening to help with early detection and intervention. Once identified, treatment would include a combination of the three modalities   surgery, radiation, and chemotherapy. Surgery often may be followed by chemotherapy and/or radiation.

Prognosis
The prognosis for pancreatic cancer is very poor. Only about 25% of patients diagnosed with pancreatic cancer live past the first year. Early detection of risk factor remains the best way to improve prognosis. In case you have a concern or query you can always consult an expert & get answers to your questions!

Pancreatic Cancer - 8 Common Signs You Must Be Aware Of!

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

An inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

Causes
Pancreatitis may be caused due to various reasons:
1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also a back flow of the bile into the pancreas can cause pancreatitis. 
2. Alcohol: Long time alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.
3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.

Symptoms: 
1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant, and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.
2. Swollen abdomen: Pancreatitis may cause your abdominal area to swell up and become tender.
3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.
4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.
5. Rapid pulse: Pancreatitis affects the rate, at which the heart beats, causing a rapid increase in the pulse rate.

Causes and Symptoms of Pancreatitis

A pancreatic transplantation or pancreas transplantation refers to the surgical procedure, which involves replacing a dysfunctional pancreas with a healthy one.  The donor of the pancreas is usually a deceased person. Pancreas is an important organ of the body as it produces several important hormones, which play a significant role of regulating our body cycles. Pancreas transplantation is usually performed for the treatment of type 1 diabetes which is linked to the inability of the pancreas to produce the insulin hormone.

A pancreatic transplant is considered as one of the potential cures for type 1 diabetes. However it is not considered to be a standard treatment due to complications, such as:

Rejection of graft by the recipient body or similar complications
The medications which are given to prevent the rejection can have serious side effects too
Certain complications like blood clots or infections can occur following the procedure
Failure to control the blood sugar levels and rejection of the graft or complete pancreatic failure are Common complications that occur after a pancreas transplant.
These are the primary reasons why pancreas transplant is often considered to be one of the last measures of treating diabetes. Nevertheless, there are certain conditions where a pancreas transplant is worth considering. Some of the conditions include diabetes which cannot be controlled with the usual treatment procedure, chronic poor blood sugar control, insulin reactions which turns chronic or a serious kidney disease.

Certain medications are also prescribed for anti rejection purposes. These medications need to be taken after the operation for the rest of your life to prevent rejection of the donor graft. These medications can have a few adverse side effects. Some of the side effects include hypertension, thinning of your bones, unwanted weight gain and a rise in your cholesterol levels. Swollen gums or acne are also observed in several cases.  

Often a pancreas transplant is carried out along with a kidney transplant, especially if you have a serious kidney condition. It helps to provide a healthy kidney and a pancreas and also reduces a risk of kidney damage caused due to diabetes later in the future.

Know More About Pancreatic Transplantation!

Enlarged pancreas can result beacuse of factors such as: 

An abscess in your pancreas: This refers to a dangerous formation inside the pancreas. Neglecting its occurrence can also turn out to be fatal. An abscess is a cavity containing pus that further infects the rest of the organ. Presence of harmful bacteria in the pancreas leads to such a case.
A cyst in the lining of your pancreas: Epithelial cysts in the pancreas can also cause the organ to swell up. Such cysts are mostly benign but they are accompanied by disabling pain.
Pancreatitis is one disease with an array of threats: Highly active enzymes within the organ can make its tissues wear down thus, affecting the size of your pancreas. If you are an alcoholic, you are more prone to develop this condition. It could also be contracted due to an excess of calcium or fats in the blood.
Cancer of the pancreas is dreadful too: Due to the unanticipated growth of cancer cells in the pancreas, the organ grows bigger. A person suffers from excruciating pain under the influence of this condition.
Pseudocysts in the pancreas can have serious ill effects: When benign cysts become unmanageably harmful, they result into pseudocysts. The cysts contain remains of your tissues and other damaging fluids that can increase the size of the pancreas.
An enlarged pancreas surfaces in the form of these symptoms:

The kind of stool you pass indicates a lot about your health. Oily poop can be indicative of an enlarged pancreas. Persisting diarrhea can also be a symptom of pancreatic ailments.
You may even experience an accelerated pulse rate.
You may feel feverish continually. Bouts of fever can impede your free movement and general health.
Health issues with your pancreas can make you suffer from jaundice. It could be a one- time affair or it could reappear from time to time.
Constant queasiness could hint at some underlying problem in your pancreas.
You may even lose more than a few pounds over a short span of time. Such a thing should not be taken lightly as it not only makes you look sick but also degrades your immunity.

Enlarged Pancreas - 5 Factors Behind It 

Don't wait any longer, manage your Acute Pancreatitis online with a Lybrate doctor today

Consult for Acute Pancreatitis - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES