Pancreas
The pancreas is a glandular organ in the upper abdomen, but really it serves as two glands in one: a digestive exocrine gland and a hormone-producing endocrine gland. Functioning as an exocrine gland, the pancreas excretes enzymes to break down the proteins, lipids, carbohydrates, and nucleic acids in food. Functioning as an endocrine gland, the pancreas secretes the hormones insulin and glucagon to control blood sugar levels throughout the day. Both of these diverse functions are vital to the body’s survival. Continue Scrolling To Read More Below... Click To View Large Image Related Anatomy: Body of Pancreas Common Bile Duct Head of Pancreas Kidneys Neck of Pancreas Pancreatic Notch Small Intestine Tail of Pancreas Continued From Above... Anatomy of the Pancreas The pancreas is a narrow, 6-inch long gland that lies posterior and inferior to the stomach on the left side of the abdominal cavity. The pancreas extends laterally and superiorly across the abdomen from the curve of the duodenum to the spleen. The head of the pancreas, which connects to the duodenum, is the widest and most medial region of the organ. Extending laterally toward the left, the pancreas narrows slightly to form the body of the pancreas. The tail of the pancreas extends from the body as a narrow, tapered region on the left side of the abdominal cavity near the spleen. Glandular tissue that makes up the pancreas gives it a loose, lumpy structure. The glandular tissue surrounds many small ducts that drain into the central pancreatic duct. The pancreatic duct carries the digestive enzymes produced by endocrine cells to the duodenum. The pancreas is classified as a heterocrine gland because it contains both endocrine and exocrine glandular tissue. The exocrine tissue makes up about 99% of the pancrea Continue reading >>
Exocrine Pancreatic Insufficiency: Causes, Symptoms, And Diagnosis
Exocrine pancreatic insufficiency is a medical condition in which the pancreas does not produce enough of the molecules needed to digest foods. This condition leads to poor absorption of nutrients, weight loss, and a lack of vitamins . Two of the main causes of exocrine pancreatic insufficiency (EPI) are cystic fibrosis and chronic pancreatitis . Because the symptoms are similar to other common diseases of the stomach and intestine, exocrine pancreatic insufficiency is often underdiagnosed. EPI can be successfully treated with prescription enzymes and healthy lifestyle practices. Fast facts on exocrine pancreatic insufficiency Here are some key points about EPI. More detail and supporting information is in the main article. The pancreas is one of the organs that make up the gastrointestinal (GI) system. The main function of our GI system is to digest and absorb food. The pancreas produces amylase, protease, and lipase, three molecules known as enzymes that are necessary for the normal digestion of food. Pancreatic enzyme replacement therapy (PERT) medications are made from the pancreas of pigs. It is possible for a person to live without a pancreas. Digesting food is a complicated process. It starts in the mouth with chewing and the release of saliva. Once the food is swallowed, acids in the stomach break it down. The pancreas is an important organ that helps with the body break down food that has been eaten. After about 15 minutes, the broken-down food moves to the small intestine. Here, the pancreas provides the necessary enzymes to change the food into smaller molecules. These can then be absorbed into the bloodstream and sent on to nourish the body. The pancreas, along with the salivary and sweat glands, is one of the body's main exocrine glands. Exocrine glands re Continue reading >>
Exocrine Pancreatic Insufficiency
Author: Samer Al-Kaade, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Exocrine pancreatic insufficiency (EPI) is a condition characterized by deficiency of the exocrine pancreatic enzymes, resulting in the inability to digest food properly, or maldigestion. The etiology of this deficiency includes both pancreatic and nonpancreatic causes (see Etiology). [ 1 ] The exocrine pancreas produces 3 main types of enzymes: amylase, protease, and lipase. [ 2 ] Under normal physiologic conditions, the enzymes (specifically, lipase) break undigested triglycerides into fatty acids and monoglycerides, which are then solubilized by bile salts (see Pathophysiology). Because the exocrine pancreas retains a large reserve capacity for enzyme secretion, fat digestion is not clearly impaired until lipase output decreases to below 10% of the normal level. [ 3 ] The diagnosis of exocrine pancreatic insufficiency (EPI) is largely clinical. [ 4 ] It may go undetected because the signs and symptoms are similar to those of other GI diseases [ 5 ] or because the signs and symptoms are not always evident, due to dietary restrictions (see Presentation and Differential Diagnosis). A complete laboratory evaluation (including pancreatic function testing) is required not only to diagnose EPI but also to determine the extent of the malabsorption and assess the manifestations of the underlying disease, if present (see Workup). Management of EPI is based primarily on pancreatic enzyme replacement therapy (PERT) but may also include lifestyle modifications and vitamin supplementation as appropriate (see Treatment). The pancreas , named for the Greek words pan (all) and kreas (flesh), is a soft, lobulated, retroperitoneal organ that is 12-15 cm long and roughly J-shaped (like a hockey stick). It Continue reading >>
What Is Epi (exocrine Pancreatic Insufficiency)?
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The Exocrine Pancreas: Current Concepts Of Health And Disease
The Exocrine Pancreas: Current Concepts of Health and Disease The Exocrine Pancreas: Current Concepts of Health and Disease Development of the Pancreas - Chris Pin, University of Western Ontario Receptors for Secretagogues and other Regulatory Molecules - John A Williams, University of Michigan Bioenergetics of Exocrine Pancreas - David Cridle and Alexi Tepikin, University of Liverpool Ca2+ Signaling in Pancreatic Acinar Cells - David I Yule, University of Rochester Intracellular Pathways for Digestive Enzyme synthesis and Secretion - Guy Groblewski, University of Wisconsin and Fred Gorelick, Yale University Biosynthesis and Structure of Zymogen Granules - Xuequn Chen Regulation of Pancreatic Gene Expression in response to Diet and Hormones Pancreatic Digestive Enzyme Synthesis and its Translational Control Pancreatic Regeneration Models, Mechanisms, and Inconsistencies - Farzad Esni, University of Pittsburgh Pancreatic Proteases and Protein Digestion - Miklos Sahin-Toth, Boston University Pancreatic Lipases and Fat Digestion - Frederic Carriere, CNRS, Marseille Pancreatic Amylase and Carbohydrate Digestion Secretion of Insulin in Response to Diet and Hormones - Elizabeth Mann and Melena Bellin, University of Minnesota Regulation of Pancreatic Exocrine Function by Islet Hormones Secretion of the Human Exocrine Pancreas in Health and Disease - Philip A Hart and Darwin L Conwell, Ohio State University Regulation of Pancreatic Fluid and Electrolyte Secretion - Hiroshi Ishiguro, Satoro Naruse and Martin Steward Molecular Mechanisms of Pancreatic Bicarbonate Secretion - Min Goo Lee and Shmeul Muallem Ion Channels in Pancreatic Duct Physiology - Peter Hegyi, Hungary Structure-Function Relationships of CFTR in Health and Disease: The Pancreas Story - Mohamad Bouhamdan, Xie Yo Continue reading >>
Exocrine Pancreatic Insufficiency (epi)
Home Patient Information Other Pancreas Ailments EXOCRINE PANCREATIC INSUFFICIENCY (EPI) Exocrine pancreatic insufficiency (EPI) is a condition characterized by deficiency of the exocrine pancreatic enzymes, resulting in the inability to digest food properly, or maldigestion. EPI is associated with certain diseases and conditions that affect the pancreas. Some of these diseases you are born with, like cystic fibrosis, while others may occur later in life, as is the case with chronic pancreatitis. EPI may be associated with chronic pancreatitis and cystic fibrosis. If you have one of these conditions and symptoms of EPI, we recommend that you talk to your doctor. Chronic pancreatitis (CP) is the most common cause of EPI in adults. Over the course of years the inflammation can lead to irreversible damage to the pancreas, including the cells that secrete pancreatic digestive enzymes and the cells that produce insulin leading to diabetes. Cystic fibrosis (CF) is an inherited genetic condition that leads to chronic disease that mainly affects the lungs and digestive and reproductive systems. In patients with CF, a thick, sticky mucus is produced in certain organs throughout the body, most commonly in the lungs and digestive system, including the pancreas. Many people living with CF are unable to properly digest food because they may also have EPI. If you have exocrine pancreatic insufficiency (EPI), your body cannot properly digest fats, proteins, and carbohydrates in the food you eat. In addition to preventing adequate digestion, EPI produces uncomfortable gastrointestinal (GI) symptoms. Only your doctor can tell if your GI symptoms are due to EPI or another digestive condition. That is why it is so important to talk to your doctor about your medical history and all of you Continue reading >>
The Pancreas And Its Functions
The pancreas is an organ located in the abdomen. It plays an essential role in converting the food we eat into fuel for the body's cells. The pancreas has two main functions: an exocrine function that helps in digestion and an endocrine function that regulates blood sugar. Location of the Pancreas The pancreas is located behind the stomach in the upper left abdomen. It is surrounded by other organs including the small intestine, liver, and spleen. It is spongy, about six to ten inches long, and is shaped like a flat pear or a fish extended horizontally across the abdomen. The wide part, called the head of the pancreas, is positioned toward the center of the abdomen. The head of the pancreas is located at the juncture where the stomach meets the first part of the small intestine. This is where the stomach empties partially digested food into the intestine, and the pancreas releases digestive enzymes into these contents. The central section of the pancreas is called the neck or body. The thin end is called the tail and extends to the left side. Several major blood vessels surround the pancreas, the superior mesenteric artery, the superior mesenteric vein, the portal vein and the celiac axis, supplying blood to the pancreas and other abdominal organs. Almost all of the pancreas (95%) consists of exocrine tissue that produces pancreatic enzymes for digestion. The remaining tissue consists of endocrine cells called islets of Langerhans. These clusters of cells look like grapes and produce hormones that regulate blood sugar and regulate pancreatic secretions. Functions of the Pancreas A healthy pancreas produces the correct chemicals in the proper quantities, at the right times, to digest the foods we eat. The pancreas contains exocrine glands that produce enzymes important t Continue reading >>
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What Is Pancreatic Cancer?
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. See What Is Cancer? to learn more about how cancers start and spread. Pancreatic cancer starts when cells in the pancreas start to grow out of control. The pancreas is an organ that sits behind the stomach. It's shaped a bit like a fish with a wide head, a tapering body, and a narrow, pointed tail. In adults it's about 6 inches long but less than 2 inches wide. The head of the pancreas is on the right side of the abdomen (belly), behind where the stomach meets the duodenum (the first part of the small intestine). The body of the pancreas is behind the stomach, and the tail of the pancreas is on the left side of the abdomen next to the spleen. Exocrine cells: Most of the cells in the pancreas form the exocrine glands and ducts. The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). The enzymes are first released into tiny tubes called ducts. These merge to form larger ducts, which empty into the pancreatic duct. The pancreatic duct merges with the common bile duct (the duct that carries bile from the liver), and empties into the duodenum (the first part of the small intestine) at the ampulla of Vater. Endocrine cells: Endocrine cells make up a much smaller percentage of the cells in the pancreas. These cells are in small clusters called islets (or islets of Langerhans). These islets make important hormones like insulin and glucagon (which help control blood sugar levels), and release them directly into the blood. Types of pancreatic cancer The exocrine cells and endocrine cells of the pancreas form different types of tumors. It’s very i Continue reading >>
Pancreas
Pancreas, compound gland that discharges digestive enzymes into the gut and secretes the hormones insulin and glucagon, vital in carbohydrate (sugar) metabolism, into the bloodstream. Anatomy and exocrine and endocrine functions In humans the pancreas weighs approximately 80 grams (about 3 ounces) and is shaped like a pear. It is located in the upper abdomen, with the head lying immediately adjacent to the duodenum (the upper portion of the small intestine) and the body and tail extending across the midline nearly to the spleen. In adults, most of the pancreatic tissue is devoted to exocrine function, in which digestive enzymes are secreted via the pancreatic ducts into the duodenum. The cells in the pancreas that produce digestive enzymes are called acinar cells (from Latin acinus, meaning “grape”), so named because the cells aggregate to form bundles that resemble a cluster of grapes. Located between the clusters of acinar cells are scattered patches of another type of secretory tissue, collectively known as the islets of Langerhans, named for the 19th-century German pathologist Paul Langerhans. The islets carry out the endocrine functions of the pancreas, though they account for only 1 to 2 percent of pancreatic tissue. A large main duct, the duct of Wirsung, collects pancreatic juice and empties into the duodenum. In many individuals a smaller duct (the duct of Santorini) also empties into the duodenum. Enzymes active in the digestion of carbohydrates, fat, and protein continuously flow from the pancreas through these ducts. Their flow is controlled by the vagus nerve and by the hormones secretin and cholecystokinin, which are produced in the intestinal mucosa. When food enters the duodenum, secretin and cholecystokinin are released into the bloodstream by secre Continue reading >>
The Exocrine Pancreas
For more information, see the Bookshelf Copyright Notice . The secretions of the exocrine pancreas provide for digestion of a meal into components that are then available for processing and absorption by the intestinal epithelium. Without the exocrine pancreas, malabsorption and malnutrition result. This chapter describes the cellular participants responsible for the secretion of digestive enzymes and fluid that in combination provide a pancreatic secretion that accomplishes the digestive functions of the gland. Key cellular participants, the acinar cell and the duct cell, are responsible for digestive enzyme and fluid secretion, respectively, of the exocrine pancreas. This chapter describes the neurohumoral pathways that mediate the pancreatic response to a meal as well as details of the cellular mechanisms that are necessary for the organ responses, including protein synthesis and transport and ion transports, and the regulation of these responses by intracellular signaling systems. Examples of pancreatic diseases resulting from dysfunction in cellular mechanisms provide emphasis of the importance of the normal physiologic mechanisms. The role of the pancreatic renin-angiotensin system in acinar digestive enzyme secretion and in acute pancreatitis. Tsang SW, Cheng CH, Leung PS. Regul Pept. 2004 Jul 15; 119(3):213-9. Review The role of protein synthesis and digestive enzymes in acinar cell injury. Logsdon CD, Ji B. Nat Rev Gastroenterol Hepatol. 2013 Jun; 10(6):362-70. Epub 2013 Mar 19. Review [Exocrine pancreatic insufficiency. Organic and functional deficiencies]. Zarazaga A, Garca de Lorenzo A, Culebras JM. Nutr Hosp. 1992 Mar-Apr; 7(2):93-107. Neurohumoral control of exocrine pancreatic secretion. Pandol SJ. Curr Opin Gastroenterol. 2004 Sep; 20(5):435-8. Review [ Continue reading >>
Pancreatic Exocrine Tumors
About 94% of pancreatic cancers are classified as exocrine tumors. These tumors start in the exocrine cells of the pancreas. The following table describes the most common pancreatic exocrine tumors. Adenocarcinoma is the most common type of pancreatic cancer. It accounts for about 90% of all pancreatic cancers. It begins in the cells lining the pancreatic duct. Acinar cell carcinoma is a very rare form of pancreatic cancer. Some tumors may cause excessive production of pancreatic lipase, the enzyme secreted to digest fats. Pancreatic lipase levels can be measured in the blood. Intraductal Papillary-Mucinous Neoplasm (IPMN) An IPMN is a cystic tumor that grows from the main pancreatic duct or from side branches of the duct. The tumor may appear as a finger-like (papillary) projection into the duct. An IPMN may be benign at the time of diagnosis. However, it has a risk of progressing to malignancy. This risk is high when the IPMN originates in the main pancreatic duct. An IPMN may therefore be a precursor for adenocarcinoma. Mucinous cystadenocarcinoma is a rare, malignant, cystic tumor. The cyst is filled with a thick fluid called mucin. It is similar to an IPMN but occurs in just one area of the pancreas, more commonly in the tail of the pancreas. These tumors are mostly seen in women. There are other rare types of exocrine pancreatic tumors not discussed in this table. For information about other types of exocrine pancreatic tumors, contact a Patient Central Associate . You can find information about pancreatic neuroendocrine tumors on this page . Information provided by the Pancreatic Cancer Action Network, Inc. (PanCAN) is not a substitute for medical advice, diagnosis, treatment or other health care services. PanCAN may provide information to you about physicians, Continue reading >>
The Exocrine Pancreas
The pancreas is an abdominal organ located deep in the retroperitoneum. It is a gland with mixed function: both exocrine and endocrine. In this article, we will consider just the exocrine functions of the pancreas, the synthesis of pancreatic enzymes and the regulation of enzyme secretion. Finally, we will consider the clinical relevance of the pancreatic exocrine functions. When we consider the functions of the pancreas, it is simpler to view it as a mix of two glands. We can divide the pancreas into an exocrine gland, containing the acinar and duct tissue, and the endocrine gland containing the islets of Langerhans. The majority of the pancreas is made up of the exocrine portion (85% by mass) and secretes digestive enzymes, water and bicarbonate to assist in digestion. The bicarbonate helps in neutralising the stomach acid. This is a vital part of digestion as the small intestine is not specialised to withstand the strong acids from the stomach. This is because the small intestine, unlike the stomach, lacks a thick protective mucous layer. Additionally, the digestive enzymes secreted by the pancreas reach their optimum function at a basic pH. This is achieved by the bicarbonate secretions of the pancreas. The functional unit of the exocrine pancreas includes the acinus and its duct system. The word acinus is from the Latin term for berry in a cluster. These acinar cells are specialised in enzyme synthesis, storage and secretion. The duct system modifies the aqueous secretions. This mechanism is stimulated by the parasympathetic system and inhibited by the sympathetic system. The acinar cells produce digestive enzymes on the rough endoplasmic reticulum. They are then moved to the Golgi complex where they form condensing vacuoles. These condensing vacuoles are then con Continue reading >>
Exocrine Pancreas - An Overview | Sciencedirect Topics
The exocrine pancreas is an accessory digestive organ which, under complex neuroendocrine control, secretes fluid containing digestive enzymes and sodium bicarbonate into the intestinal lumen, resulting in digestion of food and neutralization of HCl of gastric origin. Matthew A. Wallig1, John M. Sullivan2, in Haschek and Rousseaux's Handbook of Toxicologic Pathology (Third Edition) , 2013 The exocrine pancreas is strategically located in the anterior abdominal cavity adjacent to the stomach, duodenum, and liver to enable secretion of digestive enzymes into the small intestine, and to convert ingesta into absorbable proteins, carbohydrates, and lipids. Additionally, it provides a scaffold, or foundation, and microenvironment for pancreatic islet cells, which provide the embedded endocrine function of the pancreas that enables hepatic and peripheral tissue modulation of blood glucose, among other functions. In spite of its close proximity to the small intestine and potentially toxic ingesta, its unique function in producing digestive enzymes, and proximity to the common bile duct containing bile salts and acids, it is seldom a prominent target of toxicity studies. Individual case reports in humans and animals, in concert with epidemiologic studies published in medical journals, provide insight into risks of pancreatic toxicity as either idiosyncratic events with few subsequent reports, or consistent reproducible mechanisms of action that closely link exposure to drugs or xenobiotics to both acute and chronic pancreatitis. Epidemiologically, pancreatic injury has been associated with a range of environmental pollutants and with consumption of mycotoxins, and has longstanding links to alcoholism and smoking tobacco. These examples highlight the need for biomarkers that are Continue reading >>
Exocrine Pancreatic Insufficiency In Small Animals
Exocrine Pancreatic Insufficiency in Small Animals Exocrine Pancreatic Insufficiency in Small Animals By Jrg M. Steiner, DrMedVet, PhD, DACVIM, DECVIM-CA, AGAF, Associate Professor and Director, Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University Exocrine pancreatic insufficiency (EPI) is a syndrome caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas. EPI is less common than pancreatitis in both dogs and cats, but it is the second most common exocrine pancreatic disorder in both species. Pancreatic acinar atrophy is the most common cause of EPI in German Shepherds, Rough Collies, and Eurasians, whereas chronic pancreatitis is the most common cause in dogs of other breeds and cats. Less common causes of EPI in dogs and cats are pancreatic or extrapancreatic masses that lead to obstruction of the pancreatic duct. The exocrine pancreas has a remarkable functional reserve, ~90% of which must be lost before clinical signs of EPI develop. Pancreatic acinar enzymes play an integral role in the assimilation of all major macronutrients, and a lack of pancreatic digestive enzymes leads primarily to maldigestion. However, animals with EPI also show evidence of malabsorption, the pathogenetic basis of which is less well understood (also see Malabsorption Syndromes in Small Animals ). The nutrients remaining in the intestinal lumen lead to loose, voluminous feces and steatorrhea. The lack of nutrients also causes weight loss and may lead to vitamin deficiencies. In animals with EPI caused by chronic pancreatitis, destruction of pancreatic tissue may not be limited to the acinar cells, and concurrent diabetes mellitus may devel Continue reading >>
Pancreas
For other uses, see Pancreas (disambiguation). This article uses anatomical terminology; for an overview, see Anatomical terminology. The pancreas /ˈpæŋkriəs/ is a glandular organ in the digestive system and endocrine system of vertebrates. In humans, it is located in the abdominal cavity behind the stomach. It is an endocrine gland producing several important hormones, including insulin, glucagon, somatostatin, and pancreatic polypeptide, all of which circulate in the blood.[2] The pancreas is also a digestive organ, secreting pancreatic juice containing bicarbonate to neutralize acidity of chyme moving in from the stomach, as well as digestive enzymes that assist digestion and absorption of nutrients in the small intestine. These enzymes help to further break down the carbohydrates, proteins, and lipids in the chyme. The pancreas is known as a mixed gland. Structure[edit] 1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla 9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen. 13. Esophagus. 14. Stomach. 15. Pancreas: 16. Accessory pancreatic duct, 17. Pancreatic duct. 18. Small intestine: 19. Duodenum, 20. Jejunum 21–22. Right and left kidneys. The front border of the liver has been lifted up (brown arrow).[3] The pancreas is an endocrine and digestive organ that, in humans, lies in the upper left part of the abdomen. It is found behind the stomach.[4] The pancreas is about 15 cm (6 in) long.[5] Anatomically, the pancreas is divided into the head of pancreas, the neck of pancreas, the body of pancreas, and the tail of pancreas.[2] The head is surrounded by the duodenum in its concavity. The head surrounds two blood ves Continue reading >>
