Download Acute hemorrhagic pancreatitis

Faculty of allied medical
sciences
Histopathology and cytology
(MLHC-201)
Pancreatic Pathology
Inflammation of the pancreas
Prof. Dr. Noha Ragab
Learning Outcomes
By the end of this lecture, the
student will be able to :
1- Differentiate between acute,
and chronic pancreatitis.
2- Identify pancreatic tumours.
3- Identify gall bladder, and biliary
tract pathology.
Acute hemorrhagic pancreatitis
Etiology:





Gall-stones
Alcohols
Hypercalcaemia
Drugs
Infection
Pathogenesis:
 Pancreatic acinar cell injury results in
activation of pancreatic enzymes and the
enzymes consequently causes destruction
of the pancreatic parenchyma
Clinical presentation



Stabbing epigastric abdominal pain radiating to
the back
Shock
Hypercalcaemia

Laboratory investigation: elevation of
serum amylase and lipase

Gross pathology:


Focal pancreatic hemorrhage and liquefaction
Chalky, white yellow fat necrosis of adjacent
adipose tissue
Acute hemorrhagic pancreatitis
Microscopically:
 Liquifactive
necrosis
of
pancreatic
parenchyma
 Acute inflammation
 Enzymatic fat necrosis
 Necrosis
of blood vessels causes
hemorrhage
Complication:
 Acute
respiratory distress syndrome
(ARDS)
 Disseminated intra-vascular coagulopathy
(DIC)
 Pseudo cyst of pancreas
 Pancreatic calcification
Fat necrosis
Acute hemorrhagic pancreatitis
Chronic pancreatitis
Definition:
 Chronic inflammation, atrophy and fibrosis
secondary to repeated attacks of
pancreatitis
Grossly:
 Firm white fibrotic pancreas
Microscopic:
 Extensive
fibrosis
atrophy
 Chronic inflammation
and
parenchymal
Chronic pancreatitis
Clinical presentation:
1. Abdominal pain
2. Pancreatic insufficiency
3. Pancreatic calcification
4. Pseudocyst
5. Diabetes
Pancreatic Tumors
Pancreatic carcinoma
Grossly:
 On gross examination, pancreatic
carcinoma is a firm, gray, poorly
demarcated, multi-nodular mass,
often embedded in a dense
connective tissue stroma.
 Tumors of the head of the pancreas
may invade the common bile duct
and duodenal wall.
Pancreatic carcinoma
Microscopic:
 Ductal adenocarcinoma arising
from the duct epithelium
Clinically:
Abdominal pain
 Biliary obstruction
 Obstructive jaundice

Pancreatic carcinoma
GALL BLADDER AND
BILIARY TRACT
PATHOLOGY
NORMAL GALLBLADDER
NORMAL GALLBLADDER
INFLAMMATORY
CONDITIONS
Acute cholecystitis:
Definition:
Acute inflammation of the gall bladder,
usually causes by cystic duct
obstruction by gall stones


Clinical presentation:
1.
2.
3.
4.
Biliary colic
Right upper quadrant tenderness on
palpation
Nausea and vomiting
Low-grade fever and leukocytosis
Acute cholecystitis

Complications:
1.
2.
3.
Gangrene of the gall bladder
Perforation and peritonitis
Fistula formation and small
bowel obstruction by a large gall
stone)
Chronic cholecystitis:
Definition:
Ongoing chronic inflammation of the
gallbladder usually caused by gall
stones

Microscopically:
Chronic inflammation

Complication:
Calcification of the gall
(porcelain gall bladder)

bladder
Chronic cholecystitis
GALL BLADDER
CANCER
Gallbladder cancer

Clinical presentation:
1.
2.
3.
4.

Frequently asymptomatic until late in
the course
Cholecystitis
Enlarged palpable gallbladder
Biliary tract obstruction (uncommon)
Microscopically:

Adenocarcinoma
Gallbladder cancer
Gallbladder cancer
Questions
1- What is the clinical presentation of chronic
pancreatitis?
2- What does the microscopic examination of
pancreatic carcinoma reveal?
3- What is the definition of acute
cholecystitis?
4- What is the clinical presentation of
gallbladder cancer?
THANK YOU
GOOD LUCK