Chronic pancreatitis Flashcards
what is the definition of chronic pancreatitis?
Pancreatic inflammation, recurrent or persistent abdominal pain and progressive injury to the pancreas and surrounding structures, resulting in scarring and loss of function
what is the epidemiology of chronic pancreatitis?
Hereditary pancreatitis has a peak age at 10 to 14 years, juvenile idiopathic chronic pancreatitis at 19 to 23 years, alcoholic chronic pancreatitis at 36 to 44 years, and senile idiopathic chronic pancreatitis at 56 to 62 years
what is the aetiology of chronic pancreatitis?
Worldwide, the major causes of chronic pancreatitis are alcohol (70% to 80%), followed by idiopathic chronic pancreatitis and other categories.
what are the risk factors for chronic pancreatitis?
Alcohol Smoking Family history Coeliac disease Psoriasis, high fat high protein diet, tropical geography
what is the pathophysiology for chronic pancreatitis?
Unclear. Theories to explain the pathogenesis of chronic pancreatitis include: oxidative stress, toxic-metabolic factors, ductal obstruction, and necrosis-fibrosis
what are the key presentations of chronic pancreatitis?
Presence of risk factors
Abdo pain
Steatorrhoea
Jaundice
what are the signs of chronic pancreatitis?
Presence of risk factors Steatorrhoea Diabetes Low trauma fracture Abdo distension jaundice
what are the symptoms of chronic pancreatitis?
abdo pain Weight loss Nausea / vomiting Skin nodules Painful joints Shortness of breath
what are the first line and gold standard investigations for chronic pancreatitis?
CT
MRI
Endoscopic ultrasonography
Secretin-enhanced magnetic resonance cholangiopancreatography
what other tests could be done for chronic pancreatitis?
Histological exam, genetic testing, indirect pancreatic function test, faecal fat, steatocrit, first pancreatic function tests, IgG4 levels, therapeutic trial of corticosteroids
what are the differential diagnoses for chronic pancreatitis?
pancreatic cancer, acute pancreatitis, biliary colic, peptic ulcer disease
how is chronic pancreatitis managed?
Alcohol / smoking/ dietary intervention Analgesia Pancreatic enzymes plus proton-pump inhibitor Antioxidants Coeliac plexus block Endoscopic or surgical procedures ESWL Distal pancreatectomy
how is chronic pancreatitis monitored?
Patients are recommended to be seen yearly for non-invasive testing, to include laboratory blood work and perhaps stool tests to monitor for specific complications
what are the complications of chronic pancreatitis?
Pancreatic exocrine insufficiency, diabetes, pancreatic calcification, pancreatic duct obstruction, low trauma fractures
what is the prognosis of chronic pancreatitis?
Pain decreases or disappears over time
10 year survival around 20-30% lower than gen pop
