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ENDOCRINE SYSTEM Pancreatic Anatomy Located in the retroperitoneal space of the upper abdomen behind the stomach http www nlm nih gov medlineplus ency images ency fullsize 17194 jpg Anatomy Physiology Closely attached to other retroperitoneal structures Ganglia and nerves of the celiac plexus Has an exocrine and endocrine portion Exocrine secretes main source digestive enzymes Those that break down starch lipids proteins Endocrine secretes hormones Insulin glucagon somatostatin Physiology Alpha cells secrete glucagon 20 Increases BG levels by stimulating liver and other cells to release stored glucose Beta cells secrete insulin 70 Lowers BG levels by facilitating entrance of glucose into the cells for metabolism Delta cells secrete somatostatin 10 Believed to regulate release of insulin and glucagon Major Diseases Acute Pancreatitis Tissue necrosis caused by digestive enzymes being released and activated prematurely Accompanied by edema and hemorrhage Etiology Medications Viral infections Pancreatic surgery Acute Pancreatitis Clinical Manifestations Peritonitis Caused by leakage of digestive enzymes into abdominal cavity Pseudocyst Capsule and abscess formation of both structures becomes fibrotic with time Progression to chronic pancreatitis Peritoneal rigidity Accompanied by paralytic ileus Acute Pancreatitis Clinical Features Abdominal pain distention Nausea vomiting Anxiety Acute Pancreatitis Treatment Prevent damage and systemic consequences of shock Eliminate cause of pancreatitis Prognosis Can cause heart lung kidney failure and lead to death 20 mortality rate Consequence of shock Mortality rate increases with older patients with multiple comorbidities Chronic Pancreatitis Fibrosis replaces pancreatic parenchyma Irreversible progressive Produce endocrine and exocrine pancreatic insufficiency Etiology Pathogenesis Related to alcohol abuse Cystic fibrosis Heredity Chronic Pancreatitis Clinical Features Pain Malabsorption Weight Signs loss weakness of DM

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