Less common causes (to include)

long common duct, carcinoma of the head of pancreas, and other cancer, ischemia from bypass surgery, fatty necrosis, pregnancy, infections other than mumps, including varicella zoster, repeated marathon running.

The most common demographic causes of pancreatitis, (to be) _____ as follows :

Western countries - chronic alcoholism and gallstones accounting for more than 85% of all cases

Eastern countries - gallstones

Children - trauma

Adolescents and young adults - mumps

Investigations may (to include):

Blood Investigations - Full blood count, Renal function tests, Liver Function, serum calcium, serum amylase and lipase, Arterial blood gas

Imaging - Chest Xray, Abdominal Xrays and CT abdomen

Treatment

In the management of acute pancreatitis, the treatment (to be) _____to stop feeding the patient, giving him or her nothing by mouth, giving intravenous fluids to prevent dehydration, and sufficient pain control.

SSurgery (to indicate) __________________ for (i) infected pancreatic necrosis and (ii) diagnostic uncertainty and (iii)complications. The most common cause of death in acute pancreatitis (to be) ______ secondary infection.

Complications may (to include)

• multiple organ dysfunction syndrome, hypocalcemia, hyperglycemia and insulin dependent diabetes mellitus; pancreatic pseudocyst and phlegmon / abscess formation, splenic artery pseudoaneurysms, hemorrhage from erosions into splenic artery and vein, thrombosis of the splenic vein, superior mesenteric vein and portal veins, duodenal obstruction, common bile duct obstruction, progression to chronic pancreatitis

Epidemiology

Annual incidence in the U.S. is 17 per 100,000 population.

Prevalence in the US is 80,000 cases per year.

Pancreatic cancer (to be) ____a malignant tumour within the pancreatic gland. Each year about 32,000 individuals in the United States (to diagnose) _______________ with this condition, and more than 60,000 in Europe. Depending on the extent of the tumour at the time of diagnosis, the prognosis (to regard) _____ generally _______________ as poor, with few victims still alive 5 years after diagnosis, and complete remission still extremely rare.

About 95 percent of pancreatic tumors (to be) ______ adenocarcinomas. The remaining 5 percent (to include) ______________ other tumors of the exocrine pancreas.

Early diagnosis of pancreatic cancer (to be) ____ difficult because the symptoms (to be) _____ so non-specific and varied. Common symptoms (to include) _____________ abdominal pain, loss of appetite, significant weight loss and painless jaundice. All of these symptoms can (to blame) ______________ on other causes. Therefore, diagnosis of pancreatic cancer (to be) _____ often late-stage in its development.

Risk factors for pancreatic cancer (to include) _________________^:

Age

Gingivitis

Male gender

African ethnicity

Smoking

Diets high in meat

Obesity

Diabetes

Chronic pancreatitis has been linked, but is not known to be causal.

Occupational exposure to certain pesticides, dyes, and chemicals related to gasoline

Family history

Helicobacter pylori infection

Pancreatic cancer (to discover) _____ usually _______________ during the course of the evaluation of aforementioned symptoms. Liver function tests may (to show) __________ a combination of results indicative of bile duct obstruction Imaging studies, such as ultrasound or abdominal CT may (to use) ______________ to identify tumors. Endoscopic ultrasound (EUS) (to be) ______ another procedure that can (to help) ________________ visualize the tumor and obtain tissue to establish the diagnosis.

Treatment of pancreatic cancer (to depend) ______________ on the stage of the cancer. Recent advances (to make) _____________________resection (surgical removal) of tumors that (to be) ________ previously unresectable due to blood vessel involvement possible.

Patients diagnosed with pancreatic cancer typically (to have) ________________ a poor prognosis partly because the cancer usually (to cause) _______________ no symptoms early on, leading to metastatic disease at time of diagnosis. Median survival from diagnosis (to be) _____ around 3 to 6 months; 5-year survival (to be) ______ much less than 5%. ^. With 32,180 new diagnoses in the United States every year, and 31,800 deaths, mortality (tp approach) ________________ 99%, giving pancreatic cancer the #1 fatality rate of all cancers and the #4 cancer killer in the United States amongst both men and women.