The percentage of patients who will have an occurrence of a replaced right hepatic artery is:
In 15 to 20% of patients, the right hepatic artery will arise from the superior mesenteric artery and travel upward toward the liver along the posterior aspect of the head of the pancreas (referred to as a replaced right hepatic artery). It is important to look for this variation on preoperative computed tomographic (CT) scans and in the operating room (OR) so the replaced hepatic artery is recognized and injury is avoided.
The most common complication of chronic pancreatitis is:
A chronic collection of pancreatic fluid surrounded by a nonepithelialized wall of granulation tissue and fibrosis is referred to as a pseudocyst. Pseudocysts occur in up to 10% of patients with acute pancreatitis, and in 20 to 38% of patients with chronic pancreatitis, and thus, they comprise the most common complication of chronic pancreatitis.
Insulinomas associated with the multiple endocrine neoplasia (MEN) 1 syndrome:
Approximately 90% of insulinomas are sporadic, and 10% are associated with the multiple endocrine neoplasia (MEN) 1 syndrome. Insulinomas associated with the MENl syndrome are more likely to be multifocal and have a higher rate of recurrence
A pancreatic cystic neoplasms that is <3 cm, has atypical cells present, and has a solid component:
Algorith m for management of pancreatic cystic neoplasms:
CEA = carcinoembryonic antigen; CT = computed tomography; ERCP = endoscopic retrograde cholangiopancreatography; EUS = endoscopic ultrasound; FNA = fine-needle aspiration; Hx = history; IPMN = intraductal papillary mucinous neoplasm of the pancreas; MCN = mucinous cystic neoplasm; mo = month (s); MRCP = magnetic resonance cholangiopancreatography; y = year(s).
According to Ranson criteria a 67-year-old female patient suspected of acute pancreatitis presenting to the OR with sudden onset of severe abdominal pain, a serum aspartate transaminase (AST) >250 U/dL, a white blood cell (WBC) > 16,000/mm3, and a blood glucose >200 mg/dL would receive a disease classification of:
Ranson's prognostic signs of pancreatitis:
AST = aspartate transaminase; BUN = blood urea nitrogen; LDH = lactate dehydrogenase; P02 = partial pressure of oxygen; WBC = white blood cell count. Note: Fewer than 3 positive criteria predict mild, uncomplicated disease whereas more than 6 positive criteria predict severe disease with a mortality risk of 50%. Sources: Data from Ranson JHC. Etiological and prognostic factors in human acute pancreatitis.
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