Why is pancreas endocrine and exocrine

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Call for appointments. The Pancreas and Its Functions. Location of the Pancreas The pancreas is located behind the stomach in the upper left abdomen. The central section of the pancreas is called the neck or body. The thin end is called the tail and extends to the left side. Functions of the Pancreas A healthy pancreas produces the correct chemicals in the proper quantities, at the right times, to digest the foods we eat. Exocrine Function: The pancreas contains exocrine glands that produce enzymes important to digestion.

Endocrine Function: The endocrine component of the pancreas consists of islet cells islets of Langerhans that create and release important hormones directly into the bloodstream. Pancreatitis Pancreatitis is inflammation of the pancreas that occurs when pancreatic enzyme secretions build up and begin to digest the organ itself.

Precursors to Pancreatic Cancer The exact cause of pancreatic cancer is still unknown, but there are known risk factors that increase the risk of developing the disease. Pancreatic Cancer The most common form of pancreatic cancer is pancreatic adenocarcinoma, an exocrine tumor arising from the cells lining the pancreatic duct. The right side of the organ—called the head—is the widest part of the organ and lies in the curve of the duodenum, the first division of the small intestine. The tapered left side extends slightly upward—called the body of the pancreas—and ends near the spleen—called the tail.

The exocrine gland secretes digestive enzymes. These enzymes are secreted into a network of ducts that join the main pancreatic duct. This runs the length of the pancreas. These enzymes are secreted by zymogenic cells. The active enzymes trypsin and chymotrypsin are endopeptidases fission of the peptide bond within a protein.

This prevents the pancreatic tissue from digesting itself. Trypsin can activate other inactive enzymes. Carboxypeptidases are also zymogens, which are exopeptidases formed by fission of the peptide bond at the end of a protein in their active form. Active enzymes in the pancreatic digestive secretion are pancreas lipase and phospholipase A2 , which hydrolyze triglycerides and phospholipids; pancreas amylase , which breaks bonds in polysaccharides; and deoxyribonucleases , which act in the degradation of nucleic acids.

The release of these enzymes is regulated by hormones of the intestinal wall. Secretin encourages the release of the alkaline secretion in order to neutralize the acidic stomach content. Cholecystokinin stimulates the production and secretion of the enzymes. Gallstones in the common bile duct can cause secretion backflow. This can lead to premature activation of the enzymes and pancreatic self-digestion, which is referred to as acute pancreatitis see below.

The pancreas is not only a digestive gland but also an endocrine gland. As such, it produces two important hormones of the carbohydrate metabolism: insulin and glucagon , among others. The anabolic hormone insulin is produced in the beta cells and is released basally in an oscillating manner. Its half-life in the blood is only 6—8 minutes.

A high blood glucose value acts as the main stimulus for induced release. Insulin then promotes the translocation of the insulin-dependent glucose transporter type 4 GLUT4 to the plasma membrane so that the target cells can now quickly ingest glucose, which results in a decrease in the blood glucose value.

Insulin also promotes glycolysis and glycogen synthesis. Thus, the absorbed glucose is either transformed into energy or is stored. The direct antagonist of insulin is glucagon , which is produced in the alpha cells of the pancreas. At low blood glucose levels, glucagon promotes glycogenolysis and gluconeogenesis.

It inhibits glycolysis and glycogen synthesis so that the blood glucose level rises. Therefore, it is a catabolic hormone that has an antagonist effect on insulin. Somatostatin , which is produced by the delta cells, inhibits the secretion of insulin, glucagon, pancreatic enzymes, and gastric acid. Pancreatic polypeptide PP is produced by PP cells and also has an inhibitory effect.

Acute pancreatitis is characterized by autodigestion of pancreatic tissue due to the premature activation of zymogens. The most frequent causes of this clinical picture are choledocholithiasis and alcohol abuse. Affect patients experience severe pain in the upper abdomen, which can spread to the back in a belt-like manner. Nausea and vomiting can occur, sometimes accompanied by fever. Ileus and jaundice are also possible symptoms. A circulatory shock, acute kidney failure, sepsis, respiratory arrest, heart failure, bleeding in the gastrointestinal tract, and coma are other possible severe complications.

Image : Acute pancreatitis. By Herbert L. Fred, MD, and Hendrik A. An increase in gamma-glutamyl transferase GGT , alkaline phosphatase AP , serum glutamic oxaloacetic transaminase SGOT , and bilirubin points to obstruction of the common bile duct as a cause for pancreatitis.

Image : Chronic pancreatitis—axial computed tomography CT. In contrast to their role in acute pancreatitis, gallstones are not considered to be a cause of chronic pancreatitis.

In many cases, this leads to further abuse of alcohol and analgesics. Patients may also have diarrhea and weight loss due to poor feeding and increased water losses via diarrheal stools. Only in later stages of the disease can the pain disappear completely.

A decline in pancreatic tissue occurs because of the constant inflammation, and this results in an exocrine and endocrine insufficiency. Exocrine and endocrine insufficiency lead to maldigestion and intolerance of certain kinds of food mainly fats with nausea, vomiting, meteorism, weight loss, and diabetes mellitus. In earlier stages, these consequences can be reversible.

Calcifications in the pancreas can be seen on sonography and are highly suggestive of chronic pancreatitis. An abdominal computed tomography CT scan is the gold standard method for the detection of chronic pancreatitis, because calcifications are easily visualized as hyperdense lesions. Causal therapy includes strict alcohol abstinence or elimination of the underlying disease. With regard to symptoms, the acute episode should be treated as acute pancreatitis. Treatment of exocrine insufficiency consists of a diet rich in carbohydrates , with many small meals and substitution of pancreatic enzymes.

Endocrine insufficiency leads to patients becoming insulin-dependent CAVE: risk of hypoglycemia. Because there is a risk of addiction to analgesics, patients with endocrine insufficiency should be enrolled in a pain management program.

In most cases, the pain can be reduced by eliminating obstacles to drainage. This can be accomplished by endoscopic retrograde cholangiopancreatography ERCP with stent implantation; this procedure decreases the pressure in front of the stenosis.

Pain that is resistant to therapy presents an indication for surgery. Image : Pancreatic pseudocysts. They consist of an accumulation of fluids, necrotic tissue, pancreatic enzymes, and old blood. The main symptoms are pain in the upper abdomen, nausea, vomiting, and weight loss. Additional symptoms can occur because of compression of surrounding organs e. However, pancreatic pseudocysts are often asymptomatic. Complications are a spontaneous rupture in the abdominal cavity and bleeding into the cyst.

Sonography is suitable for diagnosis. On sonographic images, the cysts present as anechoic structures with a hyperechoic rim. If there are cysts with a diameter of more than 5 cm, spontaneous resolution over the ensuing months is less likely, and cyst infection, a local complication, may occur.

In these cases, surgery with cystojejunostomy or partial pancreatic resection may be necessary. Physicians very often encounter patients with diabetes. Because insulin is the only hormone in the body that can decrease the blood sugar level, insulin deficiency results in an increase in glucose in the blood hyperglycemia and increased glucose excretion in the urine glycosuria.

There may be a relative or an absolute insulin deficiency. With type 1 diabetes , there is an absolute insulin deficiency due to the destruction of the beta cells by autoantibodies. Patients with type 1 diabetes are mostly young between the ages 15 and 25 and must administer exogenous insulin all their lives.

Typical symptoms are increased thirst polydipsia , increased urination polyuria , weight loss, and reduced performance. Type 2 diabetes is more frequent by far and is characterized by resistance to insulin by peripheral cells so that a relative insulin deficiency occurs. In most patients, adiposis, hypertonia, and hypertriglyceridemia can be diagnosed. These disorders along with diabetes mellitus are referred to as metabolic syndrome. Treatment consists of a balanced diet, normalization of weight, and movement.

Oral diabetes drugs are the medications of choice. Mucoviscidosis, or cystic fibrosis , is a frequent metabolic disease that is inherited as an autosomal recessive trait.