Chủ Nhật, 13 tháng 10, 2013

Pancreas

Pancreas

What is Pancreas?


The pancreas is actually a very important organ in the body but not everyone has ample amount of knowledge about the pancreas. The pancreas is considered to be a digestive organ which is seated deep into the abdomen. This can be likened to that of the salivary glands in the mouth because just like these glands, the pancreas also release digestive enzymes that help break down foods into smaller chunks for absorption. The salivary glands help produce enzyme which help break down carbohydrates into finer pieces. The pancreas is also capable of doing this. Nonetheless, unlike the salivary glands, the pancreas is also able to produce enzymes that can break down protein molecules which the former cannot produce. It is only when people suffer from certain forms of pancreatic anomalies that they become more aware of this vital organ.








Pancreas Function


The pancreas is a unique organ because it has two distinct functions. It is composed of two types of cells which enable it to work either as an endocrine or exocrine gland. The different functions of the pancreas can be classified as either endocrine or exocrine. Specifically, these include the following:


Endocrine Functions
The pancreas, as an endocrine gland, help secretes different types of hormones. This organ is primarily known for its capacity of secreting a very important hormone called insulin. A number of people probably know something about insulin because this is the particular hormone that diabetics lack thereof. The insulin is an essential hormone which helps regulate the blood sugar levels. Aside from producing insulin, the pancreas also produces other types of hormones which are glucagon, somatostatin and the pancreatic polypeptide. The different types of hormones are produced by the varied cells of the islet of Langerhans. The following is the summary of the different types of cells found in the islets of Langerhans of the pancreas:



  • Alpha cells- produce glucagon

  • Beta cells- produce insulin

  • Delta cells- produce somatostatin

  • PP cells- produce pancreatic polypeptide


Exocrine Functions
Another unique function of the pancreas is being an exocrine gland in which this is capable of producing digestive enzymes. The pancreas specifically produces enzymes that can digest carbohydrates, fats or protein. This is capable of doing this specific function because another type of cell can be found in it. The acinar cells are the specialized types of cells scattered all over the pancreas. Aside from producing digestive enzymes, the pancreas also produces an alkaline fluid which is referred to as the pancreatic juice. This is especially produced as a form of response to secretin and cholecystokinin. The digestive enzymes produced by the pancreas to fulfill its exocrine function include the pancreatic lipase, pancreatic amylase, trypsin and chymotrypsin. There’s also an acinar cell called the centroacinar cell which is responsible for a bicarbonate and salt solution into the intestine.


Regulatory
The pancreas is also able to control the secretion of hormones. As a form of sympathetic or adrenergic response, alpha 2 increases alpha cells secretion but decreases secretions from beta cells. On the other hand, the parasympathetic response (muscarinic) of the pancreas increases both alpha and beta cells secretions which are specifically done by M3.


Pancreas Location


As previously mentioned, the pancreas is an organ situated deep into the abdomen. Its anatomical location makes tumor in the pancreas difficult to detect by mere palpation. To give you an idea about the location of the pancreas, you may try to do this. Touch your thumb to your pinkie while the three other fingers are together. You may then place your hand at the xiphoid process on the center of your abdomen. The three fingers should be pointing to the left. This can be reckoned as the probable location of your pancreas.


Pancreas Problems


There can also be certain problems that may arise from the pancreas. Again, due to the deep location of the pancreas, problems in it, especially tumor formation, cannot be easily detected. Problems developing within the pancreas can either be non-malignant or malignant. A slight injury to the pancreas (i.e. a puncture) would lead to serious complications. In 1896, Professor Hans Chiari was the first person to conduct a clinical study on the diseases that may probably affect the pancreas. He pointed out that infectious organisms cannot be pointed out as the possible culprits of diseases relating to the pancreas. Rather, this can entirely be due to the premature activation of these pancreatic enzymes especially due to a mutation in the trypsinogen gene which makes up the major digestive enzyme called trypsin. It was only after almost a hundred years that this hypothesis was proven by Professor Whitcomb circa 1996. It has been established that the premature activation of the digestive enzymes would lead to the autodigestion of the pancreas and as well as the islets in it. This phenomenon can be accounted for the development of pancreatitis. This may only begin as an acute pancreatitis but may later on become a chronic problem. This is also believed to be the primary etiology of hereditary pancreatitis. In certain instances wherein the islet cells are damaged, diabetes mellitus may eventually result.


Pancreas Anatomy


The pancreas is composed of two different types of parenchymal tissues. These can be determined through a staining process which then viewed under the microscope. The two types of cells found in the pancreas are the islets of Langerhans and the acinar cells. Under a microscope, these cells assume different appearance. The islets form spherical clusters and are often lightly stained. On the other hand, the pancreatic acini have a darker shade and form small, berry-shaped clusters. The pancreas is also made up of glandular tissues. It has its own duct system. The primary duct of the pancreas is the pancreatic duct which stretches on the entire pancreas. Its diameter is about one-sixteenth of an inch. The ampulla of vater is formed in the junction of the pancreatic duct and the common bile duct. Generally, it is composed of five different parts which are the head, neck, body, tail and the uncinate. The uncinate contains two important structures which are the superior mesenteric artery and vein.

Pancreas Pain


Pain coming from the pancreas is oftentimes confused with ordinary stomach pains. Thence, individuals are not initially alarmed by their condition. You could suspect yourself to be suffering from a pancreatic disease when the pain is localized at the middle quadrant of the abdomen. The pain especially becomes more prominent when one is eating or drinking which almost all the time coincides with pancreatitis and pancreatic cancer.



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Symptoms
Initially, pain is felt whenever something goes wrong with the pancreas. As the condition progresses, other symptoms may also manifest such as:



  • Jaundice

  • Nausea

  • Vomiting

  • Bleeding (which may be present in severe cases)


The progression of the disease may also cause severe, drilling pain. Some would even experience pancreatic colic.


Causes
The primary cause of pancreatic pain can be due to inflammation such that of in pancreatitis. The presence of tumor in the pancreas would also likely lead to a painful sensation due to the possible compression over the affected area.


Treatment
Pancreatic pain treatment can be dealt with primarily by putting the affected individual on NPO (nothing per orem). Painkillers are also effective in dealing with the condition. This is to temporarily halt the production of digestive enzymes which aggravates the pain. The patient can still be however nourished through intravenous infusions of the essential nutrients. The patient should also undergo several laboratory workups to further confirm the condition. Prevention of organ damage is also a priority. While waiting for the results, fluids and electrolytes may as well be supplemented. Soon as the underlying condition has been fully determined, this is the time that further treatment is indicated. For instance, if the presence of gallbladder or pancreatic stone is the primary cause of pain, then removal of the stone would be the treatment for it. So as to avoid relapse, one should learn how to fast. Sometimes, the patient may also be subjected to gastric decompression.


Pancreatic Cancer


Pancreatic cancer is considered to be one of the aggressive types of cancer and this oftentimes appalls a number of people because of its deadly nature. Statistically speaking, pancreatic cancer reaps about 35,000 thousand lives each year. This can be considered a really mulish type of cancer because this is resistant to the conventional modes of treating cancer. What makes pancreatic cancer difficult to treat is that this is oftentimes difficult to detect and whenever it is detected, the condition has already progressed and cancer cells have metastasized to other parts of the body and surgery may only be effective if and only if the cancer is at its earlier stages. Thus, the only hope to curing this condition is through early detection and surgery, if possible. The common means of medical management for pancreatic cancer is chemotherapy because the use of radiotherapy as a mode of treatment is still controversial.


Pancreas Diagram


Picture (Diagram) of Pancreas…













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