Pancreas

Apr 14, 2012 , Jiří Dyntr

slinivka.jpg - kopie
slinivka.jpg - kopie
The functions of the pancreas can be divided into two groups. The first function of the pancreas is the digestion of food, all its components - proteins, carbohydrates and fats. The second function of the pancreas is endocrine. It produces hormones insulin, glucagon and somatostatin, which play a vital role in the metabolism of sugars. The failure of the endocrine function of the pancreas causes a disease called diabetes.

Pancreas

Pancreas is a 12-16 cm long lobed gland stored in the abdominal cavity below the diaphragm, close to the stomach, small intestine and liver. We distinguish three main parts, the head, body and tail. Its main features include the production of pancreatic juice, which significantly contributes to the digestion of food in the small intestine. In addition, it is also the source of some important hormones that are involved in the metabolism of sugars. Overall, it can be said that the pancreas is extremely important for human metabolism, and if it malfunctions due to a disease, complications are always very serious.

Functions of pancreas

The pancreas is an important organ that plays an essential role in the body. The pancreas can be divided according to its function into two parts, the exocrine and endocrine part.

Exocrine part of the pancreas

Most tissues of the pancreas belong to the exocrine part, thus cells producing digestive enzymes. They are then as pancreatic juice transported by ducts to the initial part of the small intestine, where they are very important for the digestion of all basic food components, i.e. proteins, carbohydrates and fats. However, the enzymes to properly function must first be activated. This activation of course can not take place in the pancreas, since it also consists of proteins and fats, which could be damaged by the enzymes. The enzymes in the intestine are activated by bile. The bile is supplied from the liver by the cystic duct, which leads into the common bile duct where also leads the pancreatic duct just before the small intestine. After activating these enzymes they are able to chemically digest the food coming from the stomach, where the first phase of digestion took place. Merging of ducts from the pancreas and the liver has its advantages, but also one big disadvantage. If a gallstone forms in the gallbladder and descends into the common bile duct, it can clog it and cause the so-called acute pancreatitis.

Endocrine part of the pancreas

The endocrine part of the pancreas is composed of small clusters, known as islets of Langerhans, which contain several types of cells, which differ in hormone production. First of these are the alpha cells producing glucagon. It is secreted into the blood when blood sugar is low and increases it. In contrast, the beta cells produce a hormone with a completely opposite effect, called insulin. It is secreted into the blood when the blood sugar is increased and causes its deposition into the tissues, thereby reducing its level in the blood. Both of these hormones work antagonistically and their alternate release from islets of Langerhans is an important mechanism by which the body compensates for fluctuations in blood glucose levels after meals and between meals. Congenital or acquired during life lack of insulin causes increased levels of sugar in the blood and many other disorders of metabolism, like diabetes. The third cell type of islets of Langerhans are gamma cells producing a hormone somatostatin, which affects the secretion of insulin and glucagon, as well as certain other gastrointestinal hormones.

Pancreatic diseases

The pancreas is an organ that can be affected by various diseases. Most often is an acute or chronic pancreatitis, but also malignant tumors.

Acute pancreatic necrosis

Acute pancreatic necrosis or acute pancreatitis is a very serious disease, because besides the very mild forms it may progress rapidly and result in the patient's death due to multiple organ failure. In addition, it can cause serious long-term complications. Acute pancreatitis belongs to the most serious acute abdomen conditions.

The causes of acute pancreatitis are various. However most common are gallstones, which can clog the common bile duct. The second most common cause of acute pancreatitis is chronic alcohol abuse.

The manifestations of acute pancreatitis include severe abdominal pain around the navel, nausea, vomiting and sometimes jaundice. At the same time, this condition is accompanied by high temperature. In more serious cases loss of consciousness or cardiac arrest and subsequent death can occur.

The diagnosis of acute pancreatitis is based on clinical, laboratory and imaging methods. Each patient is sent for blood analysis, where increased pancreatic digestive enzymes and specific inflammatory markers, or presence of bacteria is diagnosed. From the imaging methods are used X-ray, necessary to exclude any rupture of the gastrointestinal organs, abdominal sonography, or ERCP, i.e. endoscopic retrograde cholangiopancreatography.

Treatment of acute pancreatitis is to replenish fluids and ions, the administration of painkillers and, if possible, feeding the patient as soon as possible. In serious cases, the patient should be hospitalized and monitored for his vital functions and general health.

Chronic pancreatitis

Chronic inflammation of the pancreas or chronic pancreatitis is a condition resulting from long-term pathological processes that lead to damage of the pancreas and thus impairing its function. The main cause of chronic pancreatitis is alcohol.

As already mentioned, the main cause of chronic pancreatitis is long-term consumption of alcohol. Undoubtable is the influence of genetic predispositions on the emergence of this disease, which is a mutation in the CFTR gene, occurring also in a disease called cystic fibrosis. Discussed is as well an autoimmune caused chronic inflammation of the pancreas, where cells of the immune system attack their own tissues.

Symptoms of chronic pancreatitis include severe pain in the upper abdomen that comes in episodes. Also diarrhea, flatulence, nausea and a feeling of pressure in the abdomen is present.

For the diagnosis of this disease radiography and ERCP are used, and the presence of certain chemicals in the blood is analyzed.

Treatment of chronic pancreatitis is essential, since often on its basis a malignant tumor, pancreatic carcinoma, is formed. Important measures in the treatment of this disease are absolute abstinence, change in lifestyle and reduction in fat intake. If the result of chronic pancreatitis is the development of diabetes, the blood sugar levels need to be adjusted by medication. Similarly, it is necessary to administer pancreatic digestive enzymes in the form of tablets. Finally, we can choose surgical treatment where a part or the whole organ is removed.

Pancreatic carcinoma

Pancreatic carcinoma is one of the most malignant tumors in general, which has a very poor prognosis. This is mainly due to late diagnosis due to the presence of non-specific clinical symptoms.

Manifestations of pancreatic cancer are non-specific, meaning that they can occur in a number of other, less severe, conditions. Initially, there do not have to be any manifestations. Gradually may appear fatigue, loss of appetite, vague abdominal pressure, nausea or vomiting shortly after eating. Pressure in the biliary tract frequently results in jaundice. In the case of severe pancreatic damage, diabetes or acute pancreatitis, i.e. acute pancreatic necrosis can occur. This is a warning sign, the occurrence of acute pancreatitis, if there is no excessive intake of alcohol and other risk factors. Pancreatic cancer is suspected if new diabetes is diagnosed after 60 years.

Diagnosis of pancreatic cancer results from a careful medical history, laboratory and imaging methods. Especially are used ultrasonography, CT of the abdomen and sometimes also an approach called ERCP, i.e. endoscopic retrograde cholangiopancreatography. It is also necessary to remove a sample of a tissue for histological examination that is to perform a biopsy.

The treatment of benign tumors is usually surgical when the entire tumor is removed from the body. In the case of a carcinoma, we decide depending on the type and stage of the tumor for surgical treatment, chemotherapy, or radiotherapy. In most cases, we choose a combination of these options. If the cancer is advanced, then we choose palliative treatment that does not cure the patient, but only improves his quality of life.

Conclusions...

From the above mentioned information it is clear that the proper function of the pancreas is very important. This can confirm many patients whose pancreas was damaged by one of a long list of illnesses. For most diseases we find very similar symptoms, that is, severe pain, difficulties with digestion, sometimes even shock, which can lead to heart and circulation system failure and death. Therefore it is necessary to have a proper diet and avoid risk factors, especially if you have family history of pancreatic diseases.

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