Chronic pancreatitis

Question 1

define chronic pancreatitis

Answer 1

3 month persistent history of pancreatic deterioration
– irreversible pancreatic inflammation and fibrosis

Question 2

describe the pathology behind chronic pancreatitis

Answer 2

1. persistent inflammation of pancreas
2. changes in pancreatic structure
3. obstruction of bicarbonate secretion in pancreatic lumen
4. autodigesion
5. fibrosis

Question 3

what are the causes of chronic pancreatitis?

Answer 3

1. alcohol abuse - main
2. hereditary
3. autoimmune
4. CKD
5. CF
6. idiopathic
7. trauma

Question 4

what are the symptoms for chronic pancreatitis?

Answer 4

• Similar to acute but less intense and longer lasting
• epigastric pain worse with alcohol
• nausea and vomiting
  -steatorrhea
• weight loss
  -T2DM

Question 5

how is chronic pancreatitis diagnosed?

Answer 5

1. Bloods- serum amylase and lipase- only raised if enough cells to make them, unlikely to be increased in severe cases
2. Abdo ultrasound and CT- detects pancreatic calcification and dilated pancreatic duct
3. faecal elastase ( increase)

Question 6

what is the treatment for chronic pancreatitis?

Answer 6

• alcohol cessation
  -pancreatic supps with PPI
• insulin for T2DM
• NSAIDs for abdo pain
• ERCP for surgery