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Chapter 16. Pancreas

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Regarding pancreatic anatomy, which of the following is correct?

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A. The uncinate process is located anterior to the superior mesenteric artery

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B. The blood supply of the pancreas is partly derived from the inferior mesenteric artery

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C. The body of the pancreas lies to the right of the SMA

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D. In 60% of cases, the ducts of Wirsung and Santorini empty into the duodenum independently

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E. The splenic artery usually runs posterior to the pancreatic body

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The uncinate process is posterior to the superior mesenteric vessels. The pancreas is part of the midgut, which is supplied by the SMA and its branches. The SMA/SMV delineates the separation of the head and neck of the pancreas from the pancreatic body, which lay to the left of these blood vessels. The splenic vein is posterior to the body of the pancreas, while the artery usually runs along the superior edge.

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Regarding insulinomas, which of the following is correct?

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A. Usually occur in the head of the pancreas, measure >4 cm, malignant, and single

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B. Usually occur in the tail of the pancreas, measure >4 cm, malignant, and single

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C. Usually occur in the body of the pancreas, measure <2 cm, benign, and multiple

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D. Uniformly distributed throughout the pancreas (head, body, and tail), measure <2 cm, benign, and single

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E. Usually occur in the body of the pancreas, measure <2 cm, malignant, and multiple

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Insulinoma are usually benign tumors, measuring less than 2 cm, and uniformly distributed in pancreatic tissue.

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A-33-year-old female is involved in a motor vehicle collision and found to have a complete transaction of the pancreas at the level of the pancreatic neck:

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A. Oversewing of the proximal segment and distal pancreatectomy

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B. Drainage of the proximal and distal segments

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C. Drainage of the proximal segment and oversewing of the distal segment

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D. Oversewing of the proximal segment and drainage of the distal segment

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E. Roux-en-Y pancreaticojejunostomy of the proximal pancreas and distal pancreatectomy

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The best approach for repair in this case is distal pancreatectomy and oversewing of the proximal pancreatic remnant. Pancreatic duct injury can usually be assessed by inspection of the injury.

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In the absence of duct injury, only drainage is required. Pancreatography may be considered to evaluate the duct, although it is not essential if ...

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