The document discusses various diseases and disorders of the pancreas, including pancreatic cancer, acute and chronic pancreatitis, pancreatic insufficiency, and diabetes mellitus. Pancreatic cancer, especially adenocarcinoma, is highlighted as particularly deadly, while acute pancreatitis can cause severe pain and complications if not treated promptly. Chronic pancreatitis, diabetes, and pancreatic insufficiency are also examined in detail, outlining their causes, symptoms, and potential for serious health risks.

1. MINISTRY OF HEALTH AND
SANITATION
SCHOOL OF CLINICAL SCIENCES MAKAMBO-MAKENI
PANCREATIC
PRESENTATION
Module: HISTOPATHOLOGY
LECTURER: DR. KANU

2. Introduction to Common Diseases and
Disorders Of The Pancreas
There are several common diseases, disorders, and
malfunctions of the pancreas which primarily include
pancreatic cancer, acute pancreatitis, chronic
pancreatitis, pancreatic insufficiency, hereditary
pancreatitis, and cystic fibrosis.
Identifying the causes of pancreas disorders and
malfunctions of the pancreas and evaluating those
causes can be a daunting process because the
pancreas has a degree of inaccessibility since it’s
location is sandwiched between the stomach and
the spine.

3. PANCREATIC CANCER
The absolute worst disease of the pancreas is
pancreatic cancer of which there are two major
types. Over 90% are Adenocarcinoma of the
Pancreas which occurs in the “exocrine portion”of
the pancreas which is its “digestive function”.
Pancreatic Adenocarcinoma has the worst survival
rates of all major types of cancer.
It accounts for one-third of all cancer-related deaths.
Generally, when people mention “pancreatic cancer”
they’re typically referring to Pancreatic
Adenocarcinoma.

4. Cont…
The other types of pancreas cancers are
Pancreatic Neuroendocrine Cancers. While they
are also considered a very serious type of cancer,
they are less aggressive and slow-growing versus
Adenocarcinoma.
Pancreatic Neuroendocrine Cancer occurs in the
“endocrine function” of the pancreas which
creates hormones such as insulin and glucagon
which perform as team to balance healthy levels
of blood sugar (glucose) in the bloodstream.

5. Cont…
• Malfunctions in endocrine portion of the
pancreas can lead to diabetes.
• Although diabetes is technically not a disease
of the pancreas, it can be caused by a
malfunction of the hormone producing area of
the pancreas.

6. ACUTE PANCREATITIS
Acute pancreatitis can create very intense pain that
can happen suddenly, particularly after eating.
 Essentially, acute pancreatitis is a serious
inflammation of the pancreas.
Functioning normally, digestive enzymes are “in
activated” until they enter the small intestines
where they are “activated” making them capable to
begin digesting food. With acute pancreatitis, the
digestive enzymes become activated before leaving
the pancreas.

7. Cont…
• The inflammation of the pancreas begins
when the activated enzymes begin digesting
the pancreas itself.
• Since the pancreas lies behind the stomach,
an obvious symptom of acute pancreatitis is
severe pain in the abdomen area that will also
radiate to the back.

8. Cont…
• The acute form of pancreatitis is a serious
medical condition that most often requires
admission to a hospital. Besides intense pain,
it can be deadly with a mortality rate of about
5%.

9. Causes of Acute Pancreatitis
• There can be several causes of acute
pancreatitis including gallstones that get stuck
in the bile duct, blockage of the pancreatic
duct, a diseased gall bladder, alcohol abuse,
infections.
• trauma to the pancreas, genetic disorders of
the pancreas, hormonal abnormalities,
smoking, obesity, high triglyceride levels, and
hereditary aspects.

10. Symptoms of Acute Pancreatitis
• The most obvious symptom of acute pancreatitis
is Intense pain in the stomach area radiates to the
back.
• Moderate symptoms can include nausea,
vomiting, fever, bloating, and diarrhea. When
experiencing any of these recurring symptoms,
seek medical attention.

11. Cont…
• Be very vigilant of any signs or symptoms that
could be an early warning sign of acute
pancreatitis when it is most treatable.
• Acute pancreatitis is a very serious condition
that could even result in death although most
patients completely recover with proper
treatment.

12. CHRONIC PANCREATITIS
• Chronic pancreatitis is much more severe
versus the acute pancreatitis even though the
symptoms can be similar. The chronic form of
pancreatitis is inflammation that recurs
frequently and may never heal or improve.
• In fact, it can progressively worsen over time
and can lead to permanent damage and even
complete destruction of the pancreas.

13. Cont..
• Permanent damage can lead to Type 2
Diabetes which can become both a cause and
major symptom of pancreatic cancer.
• It typically strikes younger patients of 30 to 40
years-old and is more common in men versus
women.

14. Causes of Chronic Pancreatitis
• The typical causes of chronic pancreatitis can
include very heavy alcohol abuse, blocked
pancreatic ducts or the common bile duct, gene
mutations caused by cystic fibrosis, high levels of
blood fats, and high levels of calcium in the
blood. It can be hereditary, particularly when two
or more immediate blood family members have
or had a a history of chronic pancreatitis.
• Often there are no known cause chronic
pancreatitis cases.

15. Symptoms of Chronic Pancreatitis
Chronic pancreatitis symptoms are generally the same
as the acute form of pancreatitis, but more severe.
Chronic Pancreatitis can become frequently
recurring and disabling.
Strangely, although very uncommon, the abdominal
pain can go away even though the condition may
worsen.
Symptoms can also include oily or fatty stools that
are clay-colored or pale in color.
When symptoms appear, seek immediate medical
attention. Chronic pancreatitis can be deadly.

16. EXOCRINE PANCREATIC INSUFFICIENCY
(EPI)
• The “exocrine” function of the pancreas produces
digestive enzymes which enter the small intestine
to break-down food into nutrients including fats,
proteins, and carbohydrates.
• Those nutrients provide the body’s energy
needs. If the pancreas is deficient in producing
pancreatic digestive enzymes, it will result in
reduced or even the inability to properly digest
food causing pancreatic insufficiency.

17. Pancreatic Insufficiency Symptoms
Pancreatic insufficiency symptoms include;
abdominal stomach pain,
bloating, and
diarrhea.
• The deficiency leads to malnutrition and non-
intentional weight loss.

18. Causes of Pancreatic Insufficiency
Pancreatic Insufficiency can be caused by
Chronic of Acute Pancreatitis,
 Cystic Fibrosis,
Crohn’s Disease,
 Celiac Disease, and, of course, Pancreatic
Cancer.

19. DIABETES MELLITUS
Introduction
• Technically, diabetes mellitus is not a disease of the
pancreas. But, it is a malfunctioning of the pancreas
that causes Type 2 Diabetes.
• The endocrine function of the pancreas produces
hormones including insulin an glucagon that
perform as a team to maintain a healthy level of
blood sugar (glucose) on the bloodstream.
• Glucagon interacts with the liver to increase blood
sugar when needed.

20. Cont…
• Insulin reduces blood sugar by helping the body’s
cells to receive glucose for their requirements of
energy.
• When the hormone team fails to function
properly deficient amounts of insulin cause
periods of high blood sugar in the bloodstream.
• Repeated episodes of high blood sugar can cause
Onset Type 2 Diabetes which is resistant to
insulin. Type 2 diabetes can become both a
symptom and a major cause of pancreatic cancer

21. Diabetes mellitus
• Diabetes mellitus is a condition that happens
when your blood sugar (glucose) is too high.
• It develops when your pancreas doesn’t make
enough insulin or any at all, or when your body
isn’t responding to the effects of insulin
properly.
• Diabetes affects people of all ages. Most forms
of diabetes are chronic (lifelong), and all forms
are manageable with medications and/or
lifestyle changes.

22. Cont..
• Glucose (sugar) mainly comes from
carbohydrates in your food and drinks. It’s
your body’s go-to source of energy. Your blood
carries glucose to all your body’s cells to use
for energy.

23. Cont..
• When glucose is in your bloodstream, it needs
help — a “key” — to reach its final destination.
• This key is insulin (a hormone).
• If your pancreas isn’t making enough insulin or
your body isn’t using it properly, glucose builds
up in your bloodstream, causing high blood sugar
(hyperglycemia).

24. Cont..
• Over time, having consistently high blood
glucose can cause health problems, such as
heart disease, nerve damage and eye issues.
• The technical name for diabetes is diabetes
mellitus.

25. Types of diabetes mellitus
There are several types of diabetes. The most
common forms include:
Type 1 diabetes
Type 2 diabetes
Gestational diabetes

26. Type 1 diabetes
This type is an autoimmune disease in which
your immune system attacks and destroys
insulin-producing cells in your pancreas for
unknown reasons. Up to 10% of people who have
diabetes have Type 1.
It’s usually diagnosed in children and young
adults, but it can develop at any age.

27. Type 2 diabetes
With this type, your body doesn’t make enough
insulin and/or your body’s cells don’t respond
normally to the insulin (insulin resistance). This is
the most common type of diabetes. It mainly
affects adults, but children can have it as well.
Prediabetes: This type is the stage before Type 2
diabetes. Your blood glucose levels are higher
than normal but not high enough to be officially
diagnosed with Type 2 diabetes.

28. Gestational diabetes
• This type develops in some people during
pregnancy.
• Gestational diabetes usually goes away after
pregnancy.
• However, if you have gestational diabetes,
you’re at a higher risk of developing Type 2
diabetes later in life.

29. Other types of diabetes
Other types of diabetes include:
Type 3c diabetes
Latent autoimmune diabetes in adults (LADA)
Maturity-onset diabetes of the young (MODY)
Neonatal diabetes
Brittle diabetes

30. Type 3c diabetes
• This form of diabetes happens when your
pancreas experiences damage (other than
autoimmune damage), which affects its ability
to produce insulin.
• Pancreatitis, pancreatic cancer, cystic fibrosis
and hemochromatosis can all lead to pancreas
damage that causes diabetes. Having your
pancreas removed (pancreatectomy) also
results in Type 3c.

31. Latent autoimmune diabetes in adults
(LADA)
• Like Type 1 diabetes, LADA also results from
an autoimmune reaction, but it develops
much more slowly than Type 1. People
diagnosed with LADA are usually over the age
of 30.

32. Maturity-onset diabetes of the young
(MODY)
• MODY, also called monogenic diabetes,
happens due to an inherited genetic mutation
that affects how your body makes and uses
insulin.
• There are currently over 10 different types of
MODY. It affects up to 5% of people with
diabetes and commonly runs in families.

33. Neonatal diabetes
• This is a rare form of diabetes that occurs within
the first six months of life. It’s also a form of
monogenic diabetes. About 50% of babies with
neonatal diabetes have the lifelong form called
permanent neonatal diabetes mellitus. For the
other half, the condition disappears within a
few months from onset, but it can come back
later in life. This is called transient neonatal
diabetes mellitus.

34. Brittle diabetes
• Brittle diabetes is a form of Type 1 diabetes
that’s marked by frequent and severe
episodes of high and low blood sugar levels.
This instability often leads to hospitalization.
In rare cases, a pancreas transplant may be
necessary to permanently treat brittle
diabetes.

35. commonness is diabetes
• Diabetes is common. Approximately 37.3 million
people in the United States have diabetes, which
is about 11% of the population. Type 2 diabetes is
the most common form, representing 90% to
95% of all diabetes cases.
•
• About 537 million adults across the world have
diabetes. Experts predict this number will rise to
643 million by 2030 and 783 million by 2045.

36. SYMPTOMS AND CAUSES
Symptoms of diabetes include:
• Increased thirst (polydipsia) and dry mouth.
• Frequent urination.
• Fatigue.
• Blurred vision.
• Unexplained weight loss.
• Numbness or tingling in your hands or feet.
• weight loss and slow-healing cuts and sores
• Frequent skin and/or vaginal yeast infections.
The severity of symptoms can vary based on the type of diabetes
you have. These symptoms are usually more intense in Type 1
diabetes than Type 2 diabetes.

37. Other symptoms of type 1 diabetes
Symptoms of T1D can develop quickly — over a
few weeks or months.
You may develop additional symptoms that are
signs of a severe complication called diabetes-
related ketoacidosis (DKA).
DKA is life-threatening and requires immediate
medical treatment.DKA symptoms include
vomiting, stomach pains, fruity-smelling breath
and labored breathing.

38. Other symptoms of type 2 diabetes
and prediabetes cont…
• You may not have any symptoms at all, or you
may not notice them since they develop slowly.
Routine bloodwork may show a high blood
sugar level before you recognize symptoms.
• Another possible sign of prediabetes is
darkened skin on certain parts of your body
(acanthosis nigricans).

39. Gestational diabetes
• You typically won’t notice symptoms of
gestational diabetes.
• Your healthcare provider will test you for
gestational diabetes between 24 and 28
weeks of pregnancy

40. Causes diabetes
Too much glucose circulating in your bloodstream
causes diabetes, regardless of the type. However,
the reason why your blood glucose levels are high
differs depending on the type of diabetes.
• Insulin resistance
• Autoimmune disease
• Hormonal imbalances
• Pancreatic damage
• Genetic mutations

41. 1. Insulin resistance
• Type 2 diabetes mainly results from insulin
resistance. Insulin resistance happens when
cells in your muscles, fat and liver don’t respond
as they should to insulin.
• Several factors and conditions contribute to
varying degrees of insulin resistance, including
obesity, lack of physical activity, diet, hormonal
imbalances, genetics and certain medications.

42. 2. Autoimmune disease:
• Type 1 diabetes and LADA happen when your
immune system attacks the insulin-producing
cells in your pancreas.
• Long-term use of certain medications can also
lead to Type 2 diabetes, including HIV/AIDS
medications and corticosteroids

43. 3. Hormonal imbalances:
• During pregnancy, the placenta releases
hormones that cause insulin resistance. You
may develop gestational diabetes if your
pancreas can’t produce enough insulin to
overcome the insulin resistance. Other
hormone-related conditions like
acromegalyand Cushing syndrome can also
cause Type 2 diabetes.

44. 4. Pancreatic damage:
• Physical damage to your pancreas — from a
condition, surgery or injury — can impact its
ability to make insulin, resulting in Type 3c
diabetes.
5. Genetic mutations
Certain genetic mutations can cause MODY and
neonatal diabetes.

45. Complications of diabetes mellitus
Diabetes can lead to acute (sudden and severe)
and long-term complications
mainly due to extreme or prolonged high blood
sugar levels.
Acute diabetes complications
Prolong diabetes complications

46. Acute diabetes complications
Acute diabetes complications that can be life-
threatening include:
Hyperosmolar hyperglycemic state (HHS)
Diabetes-related ketoacidosis (DKA)
Severe low blood sugar (hypoglycemia)

47. Cont..
1. Hyperosmolar hyperglycemic state (HHS)
This complication mainly affects people with
Type 2 diabetes. It happens when your blood
sugar levels are very high (over 600 milligrams
per deciliter or mg/dL) for a long period, leading
to severe dehydration and confusion. It requires
immediate medical treatment.

48. Cont…
Diabetes-related ketoacidosis (DKA)
This complication mainly affects people with Type 1
diabetes or undiagnosed T1D. It happens when your
body doesn’t have enough insulin.
• If your body doesn’t have insulin, it can’t use
glucose for energy, so it breaks down fat instead.
This process eventually releases substances called
ketones, which turn your blood acidic.
• This causes labored breathing, vomiting and loss of
consciousness. DKA requires immediate medical
treatment.

49. THANK YOU