Chronic pancreatitis Flashcards
What is chronic pancreatitis?
Long-term inflammation with a progressive and permanent deterioration in pancreatic function.
Pathologically, what does chronic pancreatitis result in?
Fibrosis and reduced function of the pancreatic tissue
Name 2 causes of chronic pancreatitis, and what is the commonest?
- Alcohol -> commonest
- Smoking
- Autoimmune pancreatitis
- Gallstones
Name a symptom of chronic pancreatitis
- Epigastric pain that radiates to the back following eating
- Abdominal tenderness
- Diabetes and steatorrhoea (long term symptoms)
- Systemically unwell
1) Name an investigation used in chronic pancreatitis
2) How is chronic pancreatitis diagnosed on CT?
3) What functional test can be looked at to assess exocrine function of the pancreas if imaging is not conclusive for chronic pancreatitis?
1) CT, abdo XR
2) Pancreatic calcifications
3) Fecal elastase
Name 2 complications of chronic pancreatitis
- Chronic epigastric pain
- Loss of exocrine function
- Loss of endocrine function
- Damage and strictures to the duct system
- Formation of pseudocysts or abscesses
1) What does loss of exocrine function result in?
2) What does loss of endocrine function result in?
3) What can damage and strictures to the duct system cause?
1) Lack of pancreatic enzymes (particularly lipase) secreted into the GI tract
2) Lack of insulin, leading to diabetes
3) Obstruction in the excretion of bile and pancreatic juice
1) What is important in the management of chronic pancreatitis?
2) How can a loss of pancreatic enzymes be treated?
3) Name another aspect of the management of chronic pancreatitis
1) Abstinence of alcohol and smoking
2) Replacement pancreatic enzymes - creon
3) Subcutaneous insulin regimes if diabetes, analgesia, ERCP to manage strictures and obstruction to the biliary system. Surgery for pseudocysts, abscesses and severe pain in extreme cases
