MEDS12002 Lecture Notes - Lecture 1: Hard Copy, Celiac Artery, Pancreatitis
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Laboratory Test
Normal/Abnormal Ranges
Serum Amylase
Normal range 25 to 125 U/L
Increases with acute pancreatitis, pancreatic pseudocyst
Urine Amylase
Remains increased longer than serum amylase in episodes of acute pancreatitis
Serum Lipase
Normal range 10 to 140 U/L
Remains elevated for a longer period (up to 14 days)
Increases with pancreatitis, obstruction of the pancreatic duct, pancreatic
carcinoma
Glucose
Normal range <100mg fasting <145mg 2 hours post prandial
Increases with severe diabetes mellitus and overactivity of several of the endocrine
glands
Decreases with tumours of the islets of Langerhans in the pancreas
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• Retroperitoneal organ
• No capsule
• Lies in oblique horizontal position in
epigastric region
• Head is in C-loop of duodenum over IVC
• Body anterior to Ao, SMA and splenic vein
• Tail drapes into the splenic hilum
Normal Pancreatic Appearance
Parenchymal echotexture:
• Generally homogenous, however can appear heterogeneous if there is intra-lobular fat
infiltration
• Considered more ‘coarse’ than the liver
Contour:
• Pancreas does NOT have a capsule, it has a smooth, curvilinear contour
Indications for pancreatic ultrasound
• Pancreatic mass on another modality
• Elevated pancreatic enzymes
• Pancreatic neoplasm
• Weight loss
• Bloating
• Pancreatitis
• Epigastric pain
• Palpable abdominal mass
• Proxy pathology of biliary and bowel structures
Patient preparation
• Nil by mouth (NBM) or nothing consumed 6 – 8
hours prior to examination for adults
• Nil by mouth 6hrs for paediatrics and 4hrs for
infants
• Abstain from smoking (as this stimulates bowel gas)
• Abstain from chewing gum
• Elderly, young, and diabetic patients preferably
book in the morning
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Document Summary
Remains increased longer than serum amylase in episodes of acute pancreatitis. Remains elevated for a longer period (up to 14 days) Increases with pancreatitis, obstruction of the pancreatic duct, pancreatic carcinoma. Normal range <100mg fasting <145mg 2 hours post prandial. Increases with severe diabetes mellitus and overactivity of several of the endocrine glands. Decreases with tumours of the islets of langerhans in the pancreas. Lies in oblique horizontal position in epigastric region. Head is in c-loop of duodenum over ivc. Body anterior to ao, sma and splenic vein. Parenchymal echotexture: generally homogenous, however can appear heterogeneous if there is intra-lobular fat infiltration. Pancreas does not have a capsule, it has a smooth, curvilinear contour. Nil by mouth (nbm) or nothing consumed 6 8 hours prior to examination for adults. Nil by mouth 6hrs for paediatrics and 4hrs for infants. Abstain from smoking (as this stimulates bowel gas) Elderly, young, and diabetic patients preferably book in the morning.
