Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The pancreas is an organ approximately six inches long that is located in the
abdomen behind the stomach. The pancreas is divided into three regions; the
head, the body, and the tail. The head of the pancreas is located in the right
abdomen adjacent to the duodenum, the tail is in the left abdomen, and the body
lies between the head and the tail.
The pancreas makes several hormones that are released into the
blood--including insulin to regulate blood glucose levels (see the
Diabetes Mellitus article)-as well as digestive enzymes that aid in the digestion of
food, for example, amylase. The digestive enzymes produced by the pancreas are
combined in a bicarbonate-rich fluid also produced by the pancreas. The
pancreatic duct within the pancreas collects the bicarbonate-rich fluid and
digestive enzymes and drains them into the duodenum, the first part of the small
intestine just beyond the stomach.
The common duct (also called the common bile duct) collects bile (a fluid
that helps digest fat) produced by the liver. Like the pancreatic duct, the
common duct also drains into the duodenum. In fact, the common duct usually
joins the pancreatic duct in the head of the pancreas. The union of these two
ducts forms the ampulla of Vater which drains both bile and pancreatic fluid
into the duodenum.
What are pancreatic cysts?
Pancreatic cysts are collections (pools) of fluid within the head, body, or
tail of the pancreas. Some pancreatic cysts are true cysts, that is, they are
lined by a special layer of cells that are responsible for secreting fluid into
the cysts. Other cysts are pseudocysts and do not contain specialized lining
cells. Pancreatic cysts can range from several millimeters to several
centimeters in size. Many pancreatic cysts are benign and produce no symptoms,
but some cysts are cancerous or precancerous. (Precancerous cysts are benign
cysts that have the potential to become cancerous.)
Different types of cysts contain different types of fluids. For example,
pseudocysts that form after an attack of acute pancreatitis contain digestive
enzymes such as amylase in high concentrations. Mucinous cysts contain mucus (a
proteinaceous liquid produced by the mucinous cells that form the inside lining
of the cyst).
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause symptoms.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
Pancreatitis is a rare disease in which the pancreas becomes inflamed, occurring when digestive enzymes are activated and begin attacking the pancreas causing damage to the gland. There are two types of pancreatitis, acute and chronic. Most commonly caused by alcohol or gallstones, it can lead to bleeding in the gland, serious tissue damage, infection, and cysts. Enzymes and toxins may then enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidney.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate and exudate. The treatment of pleural effusion depends on the cause.
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.
Gallstones are "stones" that form in the gallbladder or bile ducts.
The common types of gallstones are cholesterol, black pigment, and brown pigment.
Cholesterol gallstones occur more frequently in several ethnic groups and are associated with female
gender, obesity, pregnancy,
oral hormonal therapy, rapid loss of weight,
elevated blood triglyceride levels, and Crohn's disease.
Black pigment gallstones occur when there is increased destruction of red blood cells, and brown pigment gallstones
occur when there is slow flow and infection of bile.
The majority of gallstones do not cause symptoms.
The most common symptoms of gallstones are biliary colic and cholecystitis.
Gallstones do not cause intolerance to fatty foods,
belching,
abdominal distention, or
gas.
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