Chronic Pancreatitis
SUMMARY
Symptoms
Risk Factors
Signs
Investigations
Management
--END OF SUMMARY--
Definition
Clinical Features
Symptoms
Investigations
Bedside:
Bloods:
Imaging:
Source
Dr Ray Wilson 2014
Toronto Notes 2012
Symptoms
- Can be painless
- Recurrent severe upper abdo pain, radiating to back
- Diabetes (polyuria, polydipsia, wt loss)
- Steatorrhoea
Risk Factors
- Almost always alcohol
Signs
- Same as acute (except for gallstone signs)
Investigations
- Bedside: Faecal elastase
- Blood: Secretin test (gold standard), lipase, LFT, BSL,
- Imaging: CT (calcification, dilated ducts, pseudocyst), AXR (pancreatic calcification), US (calcification, dilated ducts, pseudocyst)
Management
- Analgesia/ celiac ganglion blocks
- Abstain from alcohol
- Enzyme replacement
- ERCP to drain ducts/ Pancreatectomy
--END OF SUMMARY--
Definition
- Irreversible damage to pancrease characterised by
- pancreatic cell loss (from necrosis)
- inflammation
- fibrosis
- More likely to lead to pancreas failure than acute
- Alcohol (most common)
- Idiopathic
- Genetic
- Autoimmune (inc ESR, igG4, RF, ANA, anti-smooth miuscle antibody)
- Recurring acute pancreatitis
- Ca pancreas, endocrine tumours, lymphoma
Clinical Features
Symptoms
- Pain
- Weight Loss, steathorrhoea
- Diabetes
Investigations
Bedside:
- Faecal elastase
Bloods:
- Lipase, LFT, TG
Imaging:
- US (gallstones)
- EUS (pancreas against stomach, small gallstones)
- CT
- MRI (MRCP - pancreatic duct)
- ERCP (drain ducts)
Source
Dr Ray Wilson 2014
Toronto Notes 2012