Whipple's triad. So a patient presents with symptoms of hypoglycemia. You measure a fasting blood glucose and it's low. And those symptoms resolve when you provide glucose or some kind of sugary drink, et cetera. That's Whipple's triad.
You stick a needle into a collection that may be sterile and then you have the risk of introducing infection, and once you have infected necrosis, things can can really deteriorate.
Tom Lynn is a gastroenterologist who takes care of the vast majority or all endoscopic needs in children with pancreatic disorders, director of endoscopy for the Pancreas Care Center, and co-director of endoscopy for the division of gastroenterology
clinicalThe session will cover surgical approaches, interventional endoscopic approaches, acute pancreatitis, acute recurrent pancreatitis, chronic pancreatitis, and medical management over four hours↗
▶Ep 1 · 3:38
quoteAnything you wanted to know about the pancreas↗
▶Ep 1 · 4:05
clinicalDr. Joe Palermo is a pediatric gastroenterologist and medical lead of the total pancreatectomy and islet auto transplantation program↗
▶Ep 1 · 4:23
clinicalKen Goldschneider is director of pain management at Cincinnati Children's and professor of clinical pediatrics and anesthesia, playing a central role in pain management for patients with pancreatic diseases↗
▶Ep 1 · 4:40
clinicalDr. Maisam Abu El-Haija is a gastroenterologist, co-director of the course, and medical director of the Pancreas Care Center↗
▶Ep 1 · 4:54
clinicalTom Lynn is a gastroenterologist who takes care of the vast majority or all endoscopic needs in children with pancreatic disorders, director of endoscopy for the Pancreas Care Center, and co-director of endoscopy for the division of gastroenterology↗
▶Ep 1 · 5:17
clinicalAndrew Trout is the lead radiologist for the multidisciplinary Pancreas Care Center, assistant professor of radiology, and dual certified in pediatric radiology and nuclear medicine↗
▶Ep 1 · 5:33
clinicalDr. Deb Elder is the endocrine director for the Pancreas Care Center and will join later in the session↗
▶Ep 1 · 5:47
clinicalDr. Milton Smith is medical director of therapeutic ERCP at University of Cincinnati and will join later in the session↗
clinicalPancreatoblastoma is the most common malignant pancreatic tumor in children, typically presenting in patients less than 10 years of age↗
▶Ep 1 · 5:30
clinicalIn pancreatoblastoma cases, up to 80% have elevated alpha-fetoprotein↗
▶Ep 1 · 5:45
epidemiologicalUp to 45-50% of pancreatoblastoma cases present with metastases↗
▶Ep 1 · 6:00
clinicalPancreatoblastomas respond well to cisplatin and doxorubicin-based chemotherapy regimens↗
▶Ep 1 · 6:15
clinicalThe number one prognostic factor for pancreatoblastoma is complete surgical excision↗
▶Ep 1 · 6:30
epidemiologicalSolid pseudopapillary neoplasms are more common in young female patients in their second or third decade of life↗
▶Ep 1 · 6:45
epidemiologicalUp to 10% recurrence rate has been recorded with solid pseudopapillary neoplasms↗
▶Ep 1 · 6:45
clinicalSolid pseudopapillary tumors are indolent and slow growing, often presenting as very large masses↗
▶Ep 1 · 6:45
clinicalEnucleation of solid pseudopapillary neoplasms should be avoided due to high recurrence rates↗
▶Ep 1 · 6:45
clinicalSolid pseudopapillary lesions have excellent long-term survival with 95% 10-year survival↗
▶Ep 1 · 9:09
epidemiologicalNeuroendocrine tumors make up about 1-2% of all pancreatic tumors↗
▶Ep 1 · 9:25
epidemiologicalNeuroendocrine tumors tend to present in children over 10 years of age but are more common in middle-aged patients↗
▶Ep 1 · 9:40
clinicalIn 10% of patients, neuroendocrine tumors may present in the setting of multiple endocrine neoplasia type 1, von Hippel-Lindau, or tuberous sclerosis↗
▶Ep 1 · 10:00
epidemiologicalInsulinoma is the most common neuroendocrine tumor, accounting for almost 50% of pancreatic neuroendocrine tumors↗
▶Ep 1 · 10:15
epidemiologicalGastrinomas account for 30% of pancreatic neuroendocrine tumors↗
▶Ep 1 · 10:25
clinicalInsulinomas are typically benign, with 6% being malignant↗
▶Ep 1 · 10:25
clinicalInsulinomas present with Whipple's triad: symptoms of hypoglycemia, low fasting blood glucose, and symptom resolution with glucose administration↗
▶Ep 1 · 10:25
quoteWhipple's triad. So a patient presents with symptoms of hypoglycemia. You measure a fasting blood glucose and it's low. And those symptoms resolve when you provide glucose or some kind of sugary drink, et cetera. That's Whipple's triad.↗
▶Ep 1 · 10:35
epidemiological90% of insulinomas are solitary, 10% are associated with MEN1↗
▶Ep 1 · 18:24
epidemiologicalAutoimmune pancreatitis is more common than pancreatic neoplasms in the pediatric realm↗
▶Ep 1 · 22:05
clinicalThere is up to about a 10% risk of diabetes after just a distal pancreatectomy in the setting of otherwise normal pancreas↗
▶Ep 1 · 28:53
clinicalType 1 autoimmune pancreatitis is IgG4-mediated disease with IgG4 levels elevated in 90% of patients↗
▶Ep 1 · 29:20
clinicalType 1 AIP typically involves IgG4-related systemic disease affecting multiple organs including salivary glands, bile ducts, and retroperitoneum↗
▶Ep 1 · 29:50
clinicalType 2 AIP typically has normal IgG4 levels and is more pancreas-specific↗
▶Ep 1 · 30:10
epidemiologicalIn 30% of patients with type 2 AIP, the patient may also have inflammatory bowel disease↗
▶Ep 1 · 30:50
epidemiologicalOver 90% of children with AIP present with abdominal pain↗
▶Ep 1 · 31:05
epidemiologicalAbout 40% of children with AIP present with obstructive jaundice↗
▶Ep 1 · 31:15
epidemiologicalPositive serologies for IgG4 are described in only 22% of pediatric AIP cases in one study↗
▶Ep 1 · 31:30
epidemiologicalFocal enlargement in the head of the pancreas occurs in about 50% of pediatric AIP patients↗
▶Ep 1 · 31:45
epidemiologicalGlobal pancreatic enlargement occurs in 30% of pediatric AIP patients↗
▶Ep 1 · 31:55
epidemiologicalMain pancreatic duct irregularity is present in about two-thirds of pediatric AIP patients↗
▶Ep 1 · 32:10
epidemiologicalCommon bile duct strictures occur in 55% of pediatric AIP patients↗
▶Ep 1 · 32:20
epidemiologicalThe classic capsule-like rim sign or halo sign around the pancreas is present in only about 16% of pediatric AIP patients↗
▶Ep 1 · 32:40
clinical93% of pediatric patients with AIP respond to steroids↗
▶Ep 1 · 33:30
epidemiologicalAIP in children more commonly follows a type 2 presentation rather than type 1 or IgG4-related presentation↗
▶Ep 1 · 34:20
clinicalClinical response to corticosteroid therapy for AIP should be seen within a few weeks↗
▶Ep 1 · 34:35
clinicalImaging response to corticosteroid therapy for AIP should be anticipated after about three months↗
quoteyou really, you can very much be opening a can of worms if you're starting to stick things into the pancreas.↗
▶Ep 2 · 39:41
quoteIn the absence of true significant clinical deterioration, we, we really avoid, avoid sticking needles in the pancreas, sticking drains.↗
Welcome and Introductions: Pancreatic Disease
▶Ep 8 · 3:38
clinicalThe session will cover surgical approaches, interventional endoscopic approaches, acute pancreatitis, acute recurrent pancreatitis, chronic pancreatitis, and medical management over four hours↗
▶Ep 8 · 3:38
quoteAnything you wanted to know about the pancreas↗
▶Ep 8 · 4:05
clinicalDr. Joe Palermo is a pediatric gastroenterologist and medical lead of the total pancreatectomy and islet auto transplantation program↗
▶Ep 8 · 4:23
clinicalKen Goldschneider is director of pain management at Cincinnati Children's and professor of clinical pediatrics and anesthesia, playing a central role in pain management for patients with pancreatic diseases↗
▶Ep 8 · 4:40
clinicalDr. Maisam Abu El-Haija is a gastroenterologist, co-director of the course, and medical director of the Pancreas Care Center↗
▶Ep 8 · 4:54
clinicalTom Lynn is a gastroenterologist who takes care of the vast majority or all endoscopic needs in children with pancreatic disorders, director of endoscopy for the Pancreas Care Center, and co-director of endoscopy for the division of gastroenterology↗
▶Ep 8 · 5:17
clinicalAndrew Trout is the lead radiologist for the multidisciplinary Pancreas Care Center, assistant professor of radiology, and dual certified in pediatric radiology and nuclear medicine↗
▶Ep 8 · 5:33
clinicalDr. Deb Elder is the endocrine director for the Pancreas Care Center and will join later in the session↗
▶Ep 8 · 5:47
clinicalDr. Milton Smith is medical director of therapeutic ERCP at University of Cincinnati and will join later in the session↗
Acute Pancreatitis
▶Ep 12 · 16:45
quoteWe're not force feeding the kids. We're not pushing feeds in the face of ongoing emesis.↗
quoteYou stick a needle into a collection that may be sterile and then you have the risk of introducing infection, and once you have infected necrosis, things can can really deteriorate.↗
