PHYS 799 Lecture Notes - Lecture 30: Pancreas Divisum, Pancreatic Duct, Annular Pancreas
7 Jun 2019
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Columnar cells lining larger ducts secrete mucin (also contain the cftr channel) Fail-safes for preventing autodigestion: storage of zymogens in granules, activation of trypsinogen by duodenal enteropeptidase, trypsin inhibitors (spink1) secreted by acinar/ductal cells, cleavage of trypsin by itself (negative feedback), resistance of acinar cells to enzymes. Agenesis due to mutations in pdx1 (pancreatic duodenal homeobox 1) Pancreas divisum main pancreatic duct only drains part of head, while most of pancreas is drained by minor sphincter; elevated intraductal pressure, increased risk of chronic pancreatitis. Annular pancreas ring of pancreatic tissue encircles duodenum; duodenal obstruction, gastric distension, vomiting. Ectopic pancreas usually in submucosa of stomach or duodenum; asymptomatic, but sometimes pain or mucosal bleeding. Congenital cysts assoc. w/polycystic disease; lined by cuboidal or flattened epithelium w/thin, fibrous capsule and clear, serous fluid. Acute pancreatitis reversible, 80% due to biliary tract disease (i. e. gallstones) or alcoholism. Other causes: non-gallstone obstruction of pancreatic duct, medications, mumps, coxsackievirus, hypertriglycedemia, hyperparathyroidism/hypercalcemia, ischemia, trauma.
