Pancreas

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[size=20px]A 14-year-old boy presents to your clinic. Over the last 12 months he had multiple hospitalizations for acute pancreatitis. An extensive GI workup, including genetic analysis, shows no obvious etiology for his pancreatitis. He does not have gallstones on ultrasound. An MRCP revealed that the dorsal pancreatic duct drains into the minor papilla and the ventral duct joins with the bile duct entering the major ampulla. The ducts are not markedly dilated and there are no strictures of the ducts noted in the body of the pancreas. What would be the best next step in the management of this adolescent? A ERCP with sphincterotomy and stent placement B Transduodena…

An eight-week old infant with congenital hyperinsulinism has been stabilized and worked up including a PET-CT scan using 18-fluoro L-DOPA which suggests a focal lesion in the head of the pancreas. At exploration, you identify a large abnormal area in the head of the pancreas that has irregular borders and is slightly reddish in color. Biopsies with frozen sections suggest this to be a focal area of adenomatous islet cell hyperplasia with proliferation of islet cells and large nuclei. For this patient with congenital hyperinsulinism, the next best step in with management is A pancreaticoduodenectomy (Whipple) operation. B subtotal pancreatectomy (50 to 75%). C pan…

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