Chronic Pancreatitis Flashcards
Causes of chronic pancreatitis?
Alcohol
CF
Annular pancreas
Hypercalcaemia
Pathology of chronic pancreatitis?
Continuing inflammation of the pancreas resulting in
IRREVERSIBLE
glandular destruction
Symptoms?
Diabetes
Weight loss and anorexia
- Lack of protein absorption
Jaundice
Pancreatic pseudocysts
Epigastric pain
Signs?
Significant steatorrhoea
- Exocrine insufficiency
What is a pancreatic pseudocyst?
A collection of fluid filled with digestive enzymes in the omenta bursa
Investigations of chronic pancreatitis?
Plain AxR
USS
EUS
Bloods
Pancreatic function tests
- Lundh
- Pancreolauryl
What is the lundh test?
An endoscope is used to extract pancreatic digestive juices and test them?
What is the pancreolauryl test?
Give fluorescin dilaurate as a liquid
- This is normally broken down by cholesterol ester hydrolase
In pancreatic insufficiency it will be detected in the urine in high quantities
Blood test results?
High amylase in acute exacerbations
Low albumin
LFTs all up
INR raised
Treatment if cause is blockage?
Endoscopic treatment
What can be done if the pancreatitis is very advanced?
Total pancreatectomy
- APICT
Palliative treatment?
Opiates
Coeliac plexus block
Enzyme supplements
Complications?
Pancreatic cancer
What is APICT?
New treatment not in our lectures
Islets are removed and transplanted into the liver
Pancreatectomy then performed and islets can successfully still produce insulin and glucagon
Successful short term
