Chronic Pancreatitis Flashcards
What is chronic pancreatitis
Fibro-inflammatory disease of the pancreas with progressive irreversible damage.
What are the two types of chronic pancreatitis
Large duct - found more in males - easier to see on imaging
Small duct - found more in females - harder to see on imaging
What are the risk factors for chronic pancreatitis
Chronic alcohol excess
Smoking
What are 5 clinical features of chronic pancreatitis
Chronic pain Diabetes mellitus Steatorrhoea Epigastric tenderness Obstructive Jaundice
How would you investigate chronic pancreatitis
Blood sugar levels LFTs Serum calcium Fecal elastase Abdo USS CT Abdo MRCP ERCP
Give 3 conservative treatments of chronic pancreatitis
- Analgesia
- Refer to alcohol rehab if drinking problem
- Treatment of pancreatic insufficiency
How do you treat pancreatic insufficiency
CREON - pancreatic enzymes
What are 3 endoscopic treatments for chronic pancreatitis
Insertion of stent using ERCP
Removal of gall stones using ERCP
Endoscopic Ultrasound ( EUS ) - drain cysts
Endoscopic pancreatic sphincterotomy - ERCP
What surgical treatment is available for chronic pancreatitis
- A lateral pancreaticojejunostomy (side to side anastomosis of the pancreatic duct to the jejunum)
- pancreaticoduodenectomy (commonly termed a Whipple’s procedure)
- total pancreatectomy
What are the pharmacological treatments available
Steroids - however this is only an option for autoimmune pancreatitis
What are some of the complications of chronic pancreatitis
Decrease in vit ADEK Diabetes Pancreatic malignancy Pseudocysts Steatorrhoea Ascites
What is the prognosis of chronic pancreatitis
1/3 of patients will die
