Chronic Pancreatitis Flashcards
What is chronic pancreatitis?
when persistent inflammation of the pancreas leads to structural abnormalities:
Fibrosis
Calcification
Atrophy
What is the consequence of chronic pancreatitis which leads to the symptoms?
The chronic inflammation leads to pancreatic insufficiency
What is the main cause of chronic pancreatitis?
Alcohol 80%
What are other causes of chronic pancreatitis?
Recurrent bouts of acute pancreatitis Unknown Cystic fibrosis Haemochromatosis ductal obstructions (tumours, stones)
What is the most common cause of chronic pancreatitis in children?
Cystic fibrosis
What are the symptoms of chronic pancreatitis?
Chronic pain (worse 15-30 mins after a meal)
Steatorrhoea
Epigastric pain radiating to back
What is the difference between acute and chronic pancreatitis?
Acute - reversible inflammation
Chronic - irreversible inflammation
When do pancreatic insufficiency symptoms begin?
5-20 years after the initial pain
When does diabetes mellitus usually occur?
20 years after the onset of symptoms
What are the complications of chronic pancreatitis?
Loss of exocrine function:
Fat soluble vitamin insufficiency (A, D, E, K)
Loss of endocrine function:
Diabetes mellitus
Other: Abscesses Pseudocysts Strictures to ducts Pancreatic cancer (rarely)
Are amylase and lipase levels increased in chronic pancreatitis?
They can be raised but are not always due to the loss of cell function meaning the pancreas might not be able to secrete these enzymes.
What investigations can be done?
X ray (calcification)
CT (calcification)
ERCP (Chain of lakes pattern)
MRCP
What does the chain of lakes pattern show?
Alternating strictures and dilatation of the pancreatic ducts.
What is the management of chronic pancreatitis?
Analgesia Insulin (for diabetes) Pancreatic enzyme replacement (Creon) Drink less Eat less meat
