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Exocrine pancreas

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Abstract

Secretion of digestive enzymes is the major function of the exocrine pancreas. Normally, the pancreas very effectively protects itself against autodigestion by several mechanisms; however, when these protective mechanisms are disrupted pancreatitis can develop. This chapter covers anatomy, biochemistry and physiology; nodular hyperplasia; pancreatitis; exocrine pancreatic insufficiency; exocrine pancreatic neoplasia; pancreatic parasites and pancreatic bladder.

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Figures

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36.2 Anatomical associations of the canine pancreas. There is major variation between individual dogs in the anatomy and degree of anastomosis of the two subdivisions of the duct system. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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36.3 Acute pancreatitis in a cat. The pancreas is swollen and oedematous, and areas of haemorrhage and chalky fat necrosis are visible in the pancreatic parenchyma and adjacent mesentery. (Courtesy of Dr Steve Holloway)
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36.4 Chronic pancreatitis observed at post-mortem examination of an old dog with a prior history of several bouts of severe acute pancreatitis. Acinar cells were restricted to a few residual nodular areas of relatively normal-looking tissue adjacent to a segment of duodenum. The pancreatic pathology was not associated with any clinical signs in the 2-year period between the bouts of pancreatitis and subsequent euthanasia for an unrelated reason; during this time, serum trypsin-like immunoreactivity had fluctuated at subnormal concentrations between 2.8–3.9 μg/l, but fell short of the 2.5 μg/l value considered diagnostic for exocrine pancreatic insufficiency.
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36.6 (a) Gross and (b) microscopic images illustrating normal canine pancreas. (c) Gross and (d) microscopic images illustrating canine pancreas affected by pancreatic acinar atrophy (PAA). Normal pancreas contains small islands of endocrine tissue that secrete hormones, surrounded by copious amounts of exocrine tissue that secretes digestive enzymes. In PAA, the exocrine cells have essentially disappeared, leaving a loose collection of endocrine tissue, so while digestion is severely impaired, diabetes mellitus does not develop.
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36.7 Partial villous atrophy in a jejunal biopsy specimen from a dog with exocrine pancreatic insufficiency due to pancreatic acinar atrophy. Villi are short and stumpy with a broadened plateau at the extrusion zone, and there is evidence of folding or fusion of villi. (Reproduced from with permission from the )
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36.8 (a) Unkempt and wet appearance of the haircoat of a cat with exocrine pancreatic insufficiency. This may reflect simple greasy soiling (especially around the perineal region) and/or changes secondary to the severe cobalamin deficiency that is commonly seen in affected cats. (b–d) These three cats show the wet-looking, unkempt hair coat due to cobalamin deficiency. (Courtesy of Dr Jim Morris)
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36.9 Serum trypsin-like immunoreactivity in 100 healthy dogs, 50 dogs with small intestinal disease and 25 dogs with exocrine pancreatic insufficiency. (Reproduced from with permission from the )
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36.10 Paraneoplastic alopecia in a cat with pancreatic adenocarcinoma. (Courtesy of Dr Robert Kennis)

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