This book describes Pancreas Disorders, Diagnosis and Treatment and Related Diseases

The pancreas is a small organ in the digestive system and endocrine system:

1. 
   

   An endocrine gland (Islet cell 1%) producing several important hormones such as insulin, glucagon, somatostatin and pancreatic polypeptide.

   
   


2. 
   

   A digestive organ (Ductal Cell 99%), secreting pancreatic juice containing digestive enzymes that help the absorption of nutrients and the digestion in the small intestine

   
   

The pancreas is a firm gland measuring 20-25cm in length, 4-6cm in width and 3-4cm in depth, firmly tucked in the back of the abdominal cavity behind the stomach.

The pancreas does 2 important functions:

1. It produces enzymes which are necessary to digest food in the intestines.


2. It secretes insulin to enable every part of the body to use glucose (sugar).

Digestion

Food is first partially broken down by the acid and churning action of the stomach.

After 1-2 hours food is slowly passed into the duodenum through the pylorus.

As it travels along the rest of the small bowel, the food is broken down into tiny particles.

Nutrients are absorbed by the small intestine and used for energy and maintaining strong muscles and bones.

Unwanted substance passes into the large bowel and after 24 hours or so is passed out as stool through the rectum and anus.

Digestion of food which comprises carbohydrates (e.g. potato), proteins (e.g. meat) and fat (e.g. butter) is not possible without the function of the pancreas.

Groups of glands in the pancreas called acini produce 30 or so different enzymes each of which is accountable for breaking down clumps of different types of food into small particles for absorption.

These enzymes are secreted from the small glands in the pancreas into the small ducts and finally into the main pancreatic duct to be passed into the duodenum.

The enzymes when they are first produced in the acini are not active otherwise they could digest the pancreas.

When they pass into the duodenum, they are made active by the juice of the duodenum.

The main enzymes are:

1. Amylase for digesting carbohydrates,


2. Trypsin for digesting proteins and


3. Lipase for digesting fats.

If there are not sufficient pancreatic enzymes, fat is not digested and the stools become pale and greasy.

Endocrine Function

A healthy human pancreas contains about three million of these islet cells but their total weight is only 1 to 1.5 grams (0.03 to 0.05 ounces), or about 1% of the weight of the pancreas.

The islets of Langerhans produce hormones (insulin, glucagons, somatostatin) that help to control levels of sugar (glucose) in the blood.

Dispersed throughout the pancreas, the islets of Langerhans are made up of 5 specific types of cells.

1. Alpha cells secrete glucagon (increase glucose in blood),


2. Beta cells release insulin (reduce glucose in blood),


3. Delta cells secrete somatostatin (regulates/stops alpha and beta cells), and


4. PP cells or gamma cells (secrete pancreatic polypeptide).


5. Epsilon cells producing ghrelin (