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Tuesday, January 29, 2008

Medical Glossary

Below is a compiled list of medical terms relate to diseases of the pancreas, procedures, and other essential definitions.

A
Adenocarcinoma A cancer that develops in the lining or inner surface of an organ. More than 95 percent of prostate cancers are adenocarcinoma.
Adjuvant Therapy Treatment that is given in addition to the primary (initial) treatment.

Adjuvant treatment is an addition designed to help reach the ultimate goal. Adjuvant therapy for cancer usually refers to surgery followed by chemo- or radiotherapy to help decrease the risk of the cancer recurring (coming back).

In Latin "adjuvans" means to help and, particularly, to help reach a goal.

Amylase An enzyme produced in the pancreas and salivary glands that helps in the digestion of starches. Elevation of blood amylase is common in pancreatitis.


Anechoic
Ascites Abnormal buildup of fluid in the abdomen. Ascites can occur as a result of severe liver disease.
Auto digestion
B
Bile Duct Cancer An uncommon type of cancer that arises from the bile duct, the tube that connects the liver and the gallbladder to the small intestine.
Biliary Having to do with the gallbladder, bile ducts, or bile. The biliary system itself consists of the gallbladder and bile ducts and, of course, the bile.
Biopsy The removal of a sample of tissue for purposes of diagnosis. (Many definitions of "biopsy" stipulate that the sample of tissue is removed for examination under a microscope. This may or may not be the case. The diagnosis may be achieved by other means such as by analysis of chromosomes or genes.)
C
Cannulation
Carcinoma Cancer that begins in the skin or in tissues that line or cover body organs. For example, carcinoma can arise in the breast, colon, liver, lung, prostate, and stomach.
Celiac Disease A disorder resulting from an immune reaction to gluten, a protein found in wheat and related grains, and present in many foods. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Symptoms include frequent diarrhea and weight loss. A skin condition dermatitis herpetiformis can be associated with celiac disease. The most accurate test for celiac disease is a biopsy of the involved small bowel. Treatment is to avoid gluten in the diet. Medications are used for refractory (stubborn) celiac disease.
Celiac Plexus Block
Chemotherapy Drug therapy for cancer. Also called "chemo" for short.

Most anticancer drugs are given IV (into a vein) or IM (into muscle). Some anticancer agents are taken orally (by mouth). Chemotherapy is usually systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body.

Cholecyst The gallbladder. The word cholecyst is not much used today but it figures into a number of other terms to do with the gallbladder Cholecystectomy is removal of the gallbladder. Cholecystitis is inflammation of the gallbladder. Cholecystogram is an x-ray of the gallbladder.
Completion Pancreatectomy surgical removal of any remaining portion of the pancreas.
CT Scan Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT stands for computerized tomography.
Cyst Gastrostomy
Cystic Mass
D
Diabetes Refers to diabetes mellitus or, less often, to diabetes insipidus. Diabetes mellitus and diabetes insipidus share the name "diabetes" because they are both conditions characterized by excessive urination (polyuria).
Digestive Enzymes
Dilatation or Dilation The process of enlargement or expansion.

For example, dilatation of the eye is the process by which the pupil is temporarily enlarged with special (mydriatic) eye drops. This allows the eye care specialist to better view the inside of the eye.

The word "dilation" means the same thing as "dilatation". Both come from the Latin "dilatare" meaning "to enlarge or expand."

Distal Pancreatectomy surgical removal of part of body and entire tail of pancreas
Duodenum The first part of the small intestine. The duodenum extends from the pylorus at the bottom of the stomach to the jejunum, the second part of the small intestine. The duodenum is a common site for the formation of peptic ulcers. We often live with words without thinking where they come from or what they originally meant. That is the case for me with the duodenum. For decades, this writer knew the duodenum as a short but troubled sector of the small intestine. Only today did I learn that the duodenum began as the dodeka-daktulon, twelve fingers to the Greeks, who astutely observed that the duodenum is about 12 finger-breadths long. In German, the popular term for duodenum is Zwölffingerdarm, the 12-finger intestine.
E
Endocrine Pertaining to hormones and the glands that make and secrete them into the bloodstream through which they travel to affect distant organs. The endocrine sites include the hypothalamus, pituitary gland, pineal gland, thyroid, parathyroids, heart (which makes atrial-natriuretic peptide), the stomach and intestines, islets of Langerhans in the pancreas, the adrenal glands, the kidney (which makes renin, erythropoietin, and calcitriol), fat cells (which make leptin). the testes, the ovarian follicle (estrogens) and the corpus luteum in the ovary). Endocrine is as opposed to exocrine. (The exocrine glands include the salivary glands, sweat glands and glands within the gastrointestinal tract.)
ERCP Endoscopic retrograde cholangiopancreatography: Abbreviated ERCP. A procedure done to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x-rays and an endoscope (a long, flexible, lighted tube). Through it, the physician can see the inside of the stomach and duodenum and inject dye into the bile ducts and pancreas so they can be seen on x-ray. ERCP takes 30 minutes to 2 hours. Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum.
EUS Endoscopic ultrasound: Abbreviated EUS. A procedure that combines endoscopy and ultrasound to obtain images and information about the digestive tract and the surrounding tissue and organs. In EUS a small ultrasound transducer is installed on the tip of the endoscope allowing the transducer to get close to the organs inside the body so the resultant ultrasound images are often more accurate and detailed than ones obtained by traditional ultrasound.
Exocrine
FNA (Fine Needle Aspiration) The use of a thin needle to withdraw material from the body. For example, this method is commonly used to determine whether a nodule in the thyroid gland is benign or malignant. A fine gauge needle is placed into the nodule and a drop of blood is withdrawn. The cells are studied under the microscope by an pathologist.
F
Friable

G
Gall Bladder
Gastrectomy Surgery to remove part of all of the stomach.


Gastric Cancer Cancer of the stomach, the major organ that holds food for digestion. Worldwide, stomach cancer is the second most frequent cancer and the second leading cause of death from cancer. It can develop in any part of the stomach and spread to other organs.
Gastrostomy A surgical opening into the stomach. This opening may be used for feeding usually via a feeding tube called a gastrostomy tube. This can also be done by percutaneous endoscopic gastrostomy (PEG). PEG is a surgical procedure for placing a feeding tube but does not necessitate doing an open laparotomy (operation on the abdomen). The aim of PEG (as with any gastrostomy) is to feed those who cannot swallow. PEG may be done by a. surgeon, otolaryngologist (ENT specialist) or gastroenterologist (GI specialist). It is done in a. hospital or outpatient surgical facility. Local anesthesia (usually lidocaine or another spray) is used to anesthetize the throat. An endoscope (a flexible, lighted instrument) is passed through the mouth, throat and esophagus to the stomach. The surgeon then makes a small incision (cut) in the skin of the abdomen and pushes an intravenous cannula (an IV tube) through the skin into the stomach and sutures (ties) it in place. The patient can usually go home the same day or the next morning. Possible complications include wound infection (as in any kind of surgery) and dislodging or malfunction of the tube. Percutaneous endoscopic gastrostomy may be a mouthful (as a term) but it describes the procedure accurately. A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope to put the feeding tube in place. PEG, when feasible, takes less time, carries less risk and costs less than a classic surgical gastrostomy which requires opening the abdomen.
Gene Mutations
Glucagon
Glucose Glucose is a simple sugar (monosaccharide) that is used to increase the level of blood glucose when the level falls too low (hypoglycemia). Glucose is a glucose-elevating agent. Other glucose-elevating agents are diazoxide (Proglycem) and glucagon.

Glucose is the primary fuel used by most cells in the body to generate the energy that is needed to carry out cellular functions. When glucose levels fall to hypoglycemic levels, cells cannot function normally, and symptoms develop such as nervousness, cool skin, headache, confusion, convulsions or coma. Ingested glucose is absorbed directly into the blood from the intestine and results in a rapid increase in the blood glucose level.

H
Hemorrhage Bleeding or the abnormal flow of blood.

The patient may have an internal hemorrhage that is invisible or an external hemorrhage that is visible on the outside of the body. Bleeding into the spleen or liver is internal hemorrhage. Bleeding from a cut on the face is an external hemorrhage.

The term "hemorrhagic" comes from the Greek "haima," blood + rhegnumai," to break forth = a free and forceful escape of blood.


Hyper echoic


I
Insulin A natural hormone made by the pancreas that controls the level of the sugar glucose in the blood. Insulin permits cells to use glucose for energy. Cells cannot utilize glucose without insulin.

Diabetes: The failure to make insulin or to respond to it constitutes diabetes mellitus. Insulin is made specifically by the beta cells in the islets of Langerhans in the pancreas. If the beta cells degenerate so the body cannot make enough insulin on its own, type I diabetes results. A person with this type of diabetes must inject exogenous insulin (insulin from sources outside the body).

Insulinoma A tumor of the beta cells in areas of the pancreas called the islets of Langerhans. Although not usually cancerous, such tumors may cause the body to make extra insulin and may lead to hypoglycemia, a blood glucose (sugar) level that is too low.


IPMT (Intra Papillary Mucinous Tumor)
Islet of Langerhans (islet cells) Known as the insulin-producing tissue, the islets of Langerhans do more than that. They are groups of specialized cells in the pancreas that make and secrete hormones. Named after the German pathologist Paul Langerhans (1847-1888), who discovered them in 1869, these cells sit in groups that Langerhans likened to little islands in the pancreas. There are five types of cells in an islet: alpha cells that make glucagon, which raises the level of glucose (sugar) in the blood; beta cells that make insulin; delta cells that make somatostatin which inhibits the release of numerous other hormones in the body; and PP cells and D1 cells, about which little is known. Degeneration of the insulin-producing beta cells is the main cause of type I (insulin-dependent) diabetes mellitus.
J
Jaundice Yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment bilirubin. The yellowing extends to other tissues and body fluids. Jaundice was once called the "morbus regius" (the regal disease) in the belief that only the touch of a king could cure it.
Jejunum Part of the small intestine. It is half-way down the small intestine between its duodenum and ileum sections.

The term "jejunum" derives from the Latin "jejunus," which means "empty of food," "meager," or "hungry." The ancient Greeks noticed at death that this part of the intestine was always empty of food. Hence, the name the jejunum.

L
Lipase
Lipids Another word for "fats." (Please see the various meanings of Fat.) Lipids can be more formally defined as substances such as a fat, oil or wax that dissolves in alcohol but not in water. Lipids contain carbon, hydrogen and oxygen but have far less oxygen proportionally than carbohydrates.

Lipids are an important part of living cells. Together with carbohydrates and proteins, lipids are the main constituents of plant and animal cells.

Liver Function tests
M
Malnutrition
Metastasize The spread from one part of the body to another. When cancer cells metastasize and cause secondary tumors, the cells in the metastatic tumor are like those in the original cancer.
MRI / MRCP Abbreviation and commonly used nickname for magnetic resonance imaging, a procedure that employs a magnet connected to a computer to create images of internal structures of the body, especially the soft tissues. An MRI uses the influence of a large magnet to polarize hydrogen atoms in the tissues and then monitor the summation of the spinning energies within living cells. MRI images, particularly with soft tissue, brain and spinal cord, abdomen and joints, are clear and can be superior to the usual X-ray image.
Mucinous
N
Necrotic or Necrosis Synonymous with dead. Necrotic tissue is dead tissue.

Neoplasm A tumor. An abnormal growth of tissue. The word neoplasm is not synonymous with cancer. A neoplasm may be benign or malignant.

The word neoplasm literally means a new growth, from the Greek neo-, new + plasma, that which is formed, or a growth = a new growth.

Neuroendocrine Tumors
NG tube An NG (nasogastric) tube is one that is passed through the nose (via the nasopharynx and esophagus) down into the stomach.

An NG tube is a flexible tube made of rubber or plastic and has bidirectional potential. A nasogastric tube can thus be used to remove the contents of the stomach including air (to decompress the stomach) and small solid objects and fluid (e.g., to evacuate poison from the stomach). A nasogastric tube can also be used to instill liquids into the stomach (e.g., to feed the person).

Non-resectable not able to be removed surgically
P
Pancreas A fish-shaped spongy grayish-pink organ about 6 inches (15 cm) long that stretches across the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen and is connected to the duodenum (the first section of the small intestine). The narrow end of the pancreas, called the tail, extends to the left side of the body.
Pancreas cancer Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms. If the tumor blocks the common bile duct and bile cannot pass into the digestive system, the skin and whites of the eyes may become yellow (jaundiced), and the urine darker as a result of accumulated bile pigment called bilirubin.
Pancreatic Duct
Pancreatitis Inflammation of the pancreas. Of the many diverse causes of pancreatitis, the most common are alcohol and gallstones.
Parenchyma The key elements of an organ essential to its functioning, as distinct from the capsule that encompasses it and other supporting structures. The parenchyma is thus opposed to the connective tissue framework, or stroma, of an organ. The parenchyma of the testis consists of what are called the seminiferous tubules.
PEG or G tube Stands for percutaneous endoscopic gastrostomy, a surgical procedure for placing a feeding tube without having to perform an open laparotomy (operation on the abdomen). The aim of PEG is to feed those who cannot swallow. PEG may be done by a surgeon, otolaryngologist (ENT specialist) or gastroenterologist (GI specialist). It is done in a. hospital or outpatient surgical facility. Local anesthesia (usually lidocaine or another spray) is used to anesthetize the throat. An endoscope (a flexible, lighted instrument) is passed through the mouth, throat and esophagus to the stomach. The surgeon then makes a small incision (cut) in the skin of the abdomen and pushes an intravenous cannula (an IV tube) through the skin into the stomach and sutures (ties) it in place. The patient can usually go home the same day or the next morning. Possible complications include wound infection (as in any kind of surgery) and dislodging or malfunction of the tube. Percutaneous endoscopic gastrostomy may be a mouthful (as a term) but it describes the procedure accurately. A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope to put the feeding tube in place. PEG takes less time, carries less risk and costs less than a classic surgical gastrostomy which requires opening the abdomen.
PEJ or J tube
Peritoneum The membrane that lines the abdominal cavity and covers most of the abdominal organs. (From the Greek peri- meaning around + tonos meaning a stretching = a stretching around).


Pseudo cyst
Puestow (pancreaticojejunostomy)

R
Radiation Therapy The use of high-energy rays to damage cancer cells, stopping them from growing and dividing. Like surgery, radiation therapy is a local treatment that affects cancer cells only in the treated area.

Radiation can come from a machine (external radiation or from an a small container of radioactive material implanted directly into or near the tumor (internal radiation). Some patients receive both kinds of radiation therapy. External radiation therapy is usually given on an outpatient basis in a hospital or clinic, five days a week for several weeks. Patients are not radioactive during or after the treatment. For internal radiation therapy, the patient stays in the hospital for a few days. The implant may be temporary or permanent. Because the level of radiation is highest during the hospital stay, patients may not be able to have visitors, or may have visitors only for a short time. Once an implant is removed, there is no radioactivity in the body. The amount of radiation in a permanent implant goes down to a safe level before the patient leaves the hospital.

Resectable can be removed surgically
Roux-n-Y procedure A surgical procedure which may be done for severe obesity. The procedure involves cutting the stomach in two to create a pouch out of the smaller proximal (near) portion of the stomach, attaching it to the small intestine, bypassing a large part of the stomach and all of the duodenum. The procedure may help with weight loss because the stomach pouch is too small to hold much food and skipping the duodenum reduces the absorption of fat which is rich in calories. The procedure may be done by laparoscopy. Also called a Roux-en-Y anastomosis or Roux-en-Y gastrojejunostomy.
S
Serous Inflammation of the serous tissues of the body. The serous tissues line the lungs (pleura), heart (pericardium), and the inner lining of the abdomen (peritoneum) and organs within.

Sphincterotomy
Splenectomy An operation to remove the spleen.
Splenic Artery A large artery within the abdomen that arises from an arterial vessel called the celiac trunk, which emerges from the aorta. The splenic artery supplies blood not only to the spleen, but also to the esophagus, stomach, duodenum, liver, and pancreas.
Splenic Vein A vein formed by the union of several small veins that return blood from the stomach, pancreas and spleen. The splenic vein is a major contributor to the portal vein which goes to the liver.


Stenting
Superior Mesenteric Artery One of the arteries which arises from the abdominal portion of the aorta and distributes blood to most of the intestines.
Superior Mesenteric Vein One of the large veins which return blood from the intestines.

The inferior (lower) mesenteric vein empties into the splenic vein. The superior (upper) mesenteric vein then joins the splenic vein to create the portal vein which goes to the liver.

T
Total Pancreatectomy surgical removal of entire pancreas
V
Viable Capable of life. For example, a viable premature baby is one who is able to survive outside the womb.
W
Whipple operation (pancreaticoduodenectomy) A type of surgery used to treat pancreatic cancer. The head of the pancreas, the duodenum, a portion of the stomach, and other nearby tissues are removed.

The Whipple procedure is named for Allen O. Whipple, an American surgeon, 1881-1963 (not George Whipple, the Nobel Prize-winning pathologist, who described Whipple disease

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