Chronic Pancreatitis Flashcards
1
Q
What are the features of chronic pancreatitis?
A
- epigastric pain “bores” through to back
- pain relieved by sitting forward
- pain relieved by hot water bottle on epigastrium or back
- bloating
- steatorrhoea
- weight loss
- symptoms recurrent and worsen
2
Q
What are the causes of chronic pancreatitis?
A
- alcohol
- cystic fibrosis
- haemochromatosis
- pancreatic duct obstruction (stone / tumour)
- increased parathyroid hormone
- congenital (pancreas divisum)
3
Q
What invx are done for chronic pancreatitis?
A
- USS +CT (pancreatic calcifications confirm diagnosis
- MRCP + ERCP
- AXR shows speckled calcification
- raised glucose
- breath test e.g. 13C-hiolien
4
Q
What findings would confirm the diagnosis on USS + CT for chronic pancreatitis.
A
pancreatic calcifications
5
Q
Why do we do MRCP + ERCP?
A
MRCP (is non invasive for diagnosis of chronic pancreatitis)
ERCP - is endoscopy of the pancreatic duct , can insert stent or remove obstruction with this method.
6
Q
What finding on an AXR would indicate chronic pancreatitis?
A
speckled calcification of pancreas
7
Q
What is the treatment for chronic pancreatitis?
A
Drugs:
- Analgesia e.g coeliac plexus block
- fat soluble vitamins
- insulin
Diet:
- no alcohol
- low fat
Surgery for unremitting pain / weight loss:
- pancreatectomy
- pancreaticojejustomy (ductal drainage)
8
Q
What are the complications of chronic pancreatitis?
A
- Pseudocyst
- diabetes
- biliary obstruction
- local arterial aneurysm
- splenic vein thrombosis
- gastric varices
- pancreatic carcinoma
