common disease of the pancrease.mmmmmmmmmmmmpptx

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1. MINISTRY OF HEALTH AND SANITATION SCHOOL OF CLINICAL SCIENCES MAKAMBO-MAKENI PANCREATIC PRESENTATION Module : HISTOPATHOLOGY LECTURER: DR. KANU

2. Introduction to Common Diseases and Disorders Of The Pancreas There are several common diseases, disorders, and malfunctions of the pancreas which primarily include pancreatic cancer, acute pancreatitis, chronic pancreatitis, pancreatic insufficiency, hereditary pancreatitis, and cystic fibrosis. Identifying the causes of pancreas disorders and malfunctions of the pancreas and evaluating those causes can be a daunting process because the pancreas has a degree of inaccessibility since it’s location is sandwiched between the stomach and the spine.

3. PANCREATIC CANCER The absolute worst disease of the pancreas is pancreatic cancer of which there are two major types. Over 90% are Adenocarcinoma of the Pancreas which occurs in the “exocrine portion”of the pancreas which is its “digestive function”. Pancreatic Adenocarcinoma has the worst survival rates of all major types of cancer. It accounts for one-third of all cancer-related deaths. Generally, when people mention “pancreatic cancer” they’re typically referring to Pancreatic Adenocarcinoma.

4. Cont … The other types of pancreas cancers are Pancreatic Neuroendocrine Cancers. While they are also considered a very serious type of cancer, they are less aggressive and slow-growing versus Adenocarcinoma. Pancreatic Neuroendocrine Cancer occurs in the “endocrine function” of the pancreas which creates hormones such as insulin and glucagon which perform as team to balance healthy levels of blood sugar (glucose) in the bloodstream.

5. Cont … Malfunctions in endocrine portion of the pancreas can lead to diabetes. Although diabetes is technically not a disease of the pancreas, it can be caused by a malfunction of the hormone producing area of the pancreas.

6. ACUTE PANCREATITIS Acute pancreatitis can create very intense pain that can happen suddenly, particularly after eating . Essentially, acute pancreatitis is a serious inflammation of the pancreas. Functioning normally, digestive enzymes are “in activated” until they enter the small intestines where they are “activated” making them capable to begin digesting food. With acute pancreatitis, the digestive enzymes become activated before leaving the pancreas.

7. Cont … The inflammation of the pancreas begins when the activated enzymes begin digesting the pancreas itself. Since the pancreas lies behind the stomach, an obvious symptom of acute pancreatitis is severe pain in the abdomen area that will also radiate to the back.

8. Cont … The acute form of pancreatitis is a serious medical condition that most often requires admission to a hospital. Besides intense pain, it can be deadly with a mortality rate of about 5%.

9. Causes of Acute Pancreatitis There can be several causes of acute pancreatitis including gallstones that get stuck in the bile duct, blockage of the pancreatic duct, a diseased gall bladder, alcohol abuse, infections . trauma to the pancreas, genetic disorders of the pancreas, hormonal abnormalities, smoking, obesity, high triglyceride levels, and hereditary aspects.

10. Symptoms of Acute Pancreatitis The most obvious symptom of acute pancreatitis is Intense pain in the stomach area radiates to the back . Moderate symptoms can include nausea, vomiting, fever, bloating, and diarrhea. When experiencing any of these recurring symptoms, seek medical attention.

11. Cont … Be very vigilant of any signs or symptoms that could be an early warning sign of acute pancreatitis when it is most treatable. Acute pancreatitis is a very serious condition that could even result in death although most patients completely recover with proper treatment.

12. CHRONIC PANCREATITIS Chronic pancreatitis is much more severe versus the acute pancreatitis even though the symptoms can be similar. The chronic form of pancreatitis is inflammation that recurs frequently and may never heal or improve. In fact, it can progressively worsen over time and can lead to permanent damage and even complete destruction of the pancreas .

13. Cont.. Permanent damage can lead to Type 2 Diabetes which can become both a cause and major symptom of pancreatic cancer. It typically strikes younger patients of 30 to 40 years-old and is more common in men versus women.

14. Causes of Chronic Pancreatitis The typical causes of chronic pancreatitis can include very heavy alcohol abuse, blocked pancreatic ducts or the common bile duct, gene mutations caused by cystic fibrosis, high levels of blood fats, and high levels of calcium in the blood. It can be hereditary, particularly when two or more immediate blood family members have or had a a history of chronic pancreatitis . Often there are no known cause chronic pancreatitis cases.

15. Symptoms of Chronic Pancreatitis Chronic pancreatitis symptoms are generally the same as the acute form of pancreatitis, but more severe. Chronic Pancreatitis can become frequently recurring and disabling. Strangely , although very uncommon, the abdominal pain can go away even though the condition may worsen. Symptoms can also include oily or fatty stools that are clay-colored or pale in color. When symptoms appear, seek immediate medical attention. Chronic pancreatitis can be deadly.

16. EXOCRINE PANCREATIC INSUFFICIENCY (EPI) The “exocrine” function of the pancreas produces digestive enzymes which enter the small intestine to break-down food into nutrients including fats, proteins, and carbohydrates . Those nutrients provide the body’s energy needs. If the pancreas is deficient in producing pancreatic digestive enzymes, it will result in reduced or even the inability to properly digest food causing pancreatic insufficiency.

17. Pancreatic Insufficiency Symptoms Pancreatic insufficiency symptoms include; abdominal stomach pain, bloating , and diarrhea . The deficiency leads to malnutrition and non-intentional weight loss.

18. Causes of Pancreatic Insufficiency Pancreatic Insufficiency can be caused by Chronic of Acute Pancreatitis , Cystic Fibrosis, Crohn’s Disease , Celiac Disease, and, of course, Pancreatic Cancer.

19. DIABETES MELLITUS Introduction Technically , diabetes mellitus is not a disease of the pancreas. But, it is a malfunctioning of the pancreas that causes Type 2 Diabetes. The endocrine function of the pancreas produces hormones including insulin an glucagon that perform as a team to maintain a healthy level of blood sugar (glucose) on the bloodstream. Glucagon interacts with the liver to increase blood sugar when needed.

20. Cont … Insulin reduces blood sugar by helping the body’s cells to receive glucose for their requirements of energy. When the hormone team fails to function properly deficient amounts of insulin cause periods of high blood sugar in the bloodstream. Repeated episodes of high blood sugar can cause Onset Type 2 Diabetes which is resistant to insulin. Type 2 diabetes can become both a symptom and a major cause of pancreatic cancer

21. Diabetes mellitus Diabetes mellitus is a condition that happens when your blood sugar (glucose) is too high . It develops when your pancreas doesn’t make enough insulin or any at all, or when your body isn’t responding to the effects of insulin properly. Diabetes affects people of all ages. Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes.

22. Cont.. Glucose (sugar) mainly comes from carbohydrates in your food and drinks. It’s your body’s go-to source of energy. Your blood carries glucose to all your body’s cells to use for energy.

23. Cont.. When glucose is in your bloodstream, it needs help — a “key” — to reach its final destination. This key is insulin (a hormone). If your pancreas isn’t making enough insulin or your body isn’t using it properly, glucose builds up in your bloodstream, causing high blood sugar (hyperglycemia).  

24. Cont.. Over time, having consistently high blood glucose can cause health problems, such as heart disease, nerve damage and eye issues.   The technical name for diabetes is diabetes mellitus.

25. T ypes of diabetes mellitus There are several types of diabetes. The most common forms include: Type 1 diabetes Type 2 diabetes Gestational diabetes

26. Type 1 diabetes This type is an autoimmune disease in which your immune system attacks and destroys insulin-producing cells in your pancreas for unknown reasons. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults, but it can develop at any age.

27. Type 2 diabetes With this type, your body doesn’t make enough insulin and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults, but children can have it as well . Prediabetes : This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.

28. Gestational diabetes This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy . However, if you have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes later in life.

29. Other types of diabetes Other types of diabetes include : Type 3c diabetes Latent autoimmune diabetes in adults (LADA ) Maturity-onset diabetes of the young (MODY ) Neonatal diabetes Brittle diabetes

30. Type 3c diabetes This form of diabetes happens when your pancreas experiences damage (other than autoimmune damage), which affects its ability to produce insulin . Pancreatitis, pancreatic cancer, cystic fibrosis and hemochromatosis can all lead to pancreas damage that causes diabetes. Having your pancreas removed ( pancreatectomy ) also results in Type 3c.

31. Latent autoimmune diabetes in adults (LADA ) Like Type 1 diabetes, LADA also results from an autoimmune reaction, but it develops much more slowly than Type 1. People diagnosed with LADA are usually over the age of 30.

32. Maturity-onset diabetes of the young (MODY ) MODY , also called monogenic diabetes, happens due to an inherited genetic mutation that affects how your body makes and uses insulin . There are currently over 10 different types of MODY. It affects up to 5% of people with diabetes and commonly runs in families.

33. Neonatal diabetes This is a rare form of diabetes that occurs within the first six months of life. It’s also a form of monogenic diabetes. About 50% of babies with neonatal diabetes have the lifelong form called permanent neonatal diabetes mellitus. For the other half, the condition disappears within a few months from onset, but it can come back later in life. This is called transient neonatal diabetes mellitus.

34. Brittle diabetes Brittle diabetes is a form of Type 1 diabetes that’s marked by frequent and severe episodes of high and low blood sugar levels. This instability often leads to hospitalization. In rare cases, a pancreas transplant may be necessary to permanently treat brittle diabetes.

35. commonness is diabetes Diabetes is common. Approximately 37.3 million people in the United States have diabetes, which is about 11% of the population. Type 2 diabetes is the most common form, representing 90% to 95% of all diabetes cases.   About 537 million adults across the world have diabetes. Experts predict this number will rise to 643 million by 2030 and 783 million by 2045.

36. SYMPTOMS AND CAUSES Symptoms of diabetes include: Increased thirst (polydipsia) and dry mouth. Frequent urination. Fatigue. Blurred vision. Unexplained weight loss. Numbness or tingling in your hands or feet. weight loss and slow-healing cuts and sores Frequent skin and/or vaginal yeast infections . The severity of symptoms can vary based on the type of diabetes you have. These symptoms are usually more intense in Type 1 diabetes than Type 2 diabetes.

37. Other symptoms of type 1 diabetes Symptoms of T1D can develop quickly — over a few weeks or months. You may develop additional symptoms that are signs of a severe complication called diabetes-related ketoacidosis (DKA ). DKA is life-threatening and requires immediate medical treatment.DKA symptoms include vomiting, stomach pains, fruity-smelling breath and labored breathing .

38. Other symptoms of type 2 diabetes and prediabetes cont … You may not have any symptoms at all, or you may not notice them since they develop slowly. Routine bloodwork may show a high blood sugar level before you recognize symptoms . Another possible sign of prediabetes is darkened skin on certain parts of your body ( acanthosis nigricans ).

39. Gestational diabetes You typically won’t notice symptoms of gestational diabetes. Your healthcare provider will test you for gestational diabetes between 24 and 28 weeks of pregnancy

40. C auses diabetes Too much glucose circulating in your bloodstream causes diabetes, regardless of the type. However, the reason why your blood glucose levels are high differs depending on the type of diabetes . Insulin resistance Autoimmune disease Hormonal imbalances Pancreatic damage Genetic mutations

41. 1. Insulin resistance Type 2 diabetes mainly results from insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don’t respond as they should to insulin . Several factors and conditions contribute to varying degrees of insulin resistance, including obesity, lack of physical activity, diet, hormonal imbalances, genetics and certain medications.

42. 2. Autoimmune disease: Type 1 diabetes and LADA happen when your immune system attacks the insulin-producing cells in your pancreas . Long-term use of certain medications can also lead to Type 2 diabetes, including HIV/AIDS medications and corticosteroids

43. 3. Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance. You may develop gestational diabetes if your pancreas can’t produce enough insulin to overcome the insulin resistance. Other hormone-related conditions like acromegalyand Cushing syndrome can also cause Type 2 diabetes .

44. 4. Pancreatic damage: Physical damage to your pancreas — from a condition, surgery or injury — can impact its ability to make insulin, resulting in Type 3c diabetes . 5. Genetic mutations Certain genetic mutations can cause MODY and neonatal diabetes.

45. C omplications of diabetes mellitus Diabetes can lead to acute (sudden and severe) and long-term complications mainly due to extreme or prolonged high blood sugar levels . Acute diabetes complications Prolong diabetes complications

46. Acute diabetes complications Acute diabetes complications that can be life-threatening include: Hyperosmolar hyperglycemic state (HHS ) Diabetes-related ketoacidosis (DKA ) Severe low blood sugar (hypoglycemia )

47. Cont.. Hyperosmolar hyperglycemic state (HHS) This complication mainly affects people with Type 2 diabetes. It happens when your blood sugar levels are very high (over 600 milligrams per deciliter or mg/ dL ) for a long period, leading to severe dehydration and confusion. It requires immediate medical treatment.

48. Cont … Diabetes-related ketoacidosis (DKA ) This complication mainly affects people with Type 1 diabetes or undiagnosed T1D. It happens when your body doesn’t have enough insulin . If your body doesn’t have insulin, it can’t use glucose for energy, so it breaks down fat instead. This process eventually releases substances called ketones, which turn your blood acidic . This causes labored breathing, vomiting and loss of consciousness. DKA requires immediate medical treatment.

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