Chronic Pancreatitis

Question 1

Chronic Pancreatitis

Answer 1

inflammation of the pancreas that does not heal or imporve. It gets worse over time and leads to permanent damage. Eventually impairs a patients ability to digest food and make pancreatic hormones.

Question 2

Chronic Pancreatitis - Who does it affect?

Answer 2

Aged 35-50 years olf

Males

Question 3

Chronic Pancreatitis - Aetiology

Answer 3

O-A-TIGER-CCHH
Obstruction of duct
Autoimmune
Toxin - alcohol
Idiopathic
Genetic
Environmental
Recurrent injuries
Cystic fibrosis
Congenital anatomical abnormalities
Hereditary pancreatitis 
Hypercalcaemia 
Diet

Question 4

Chronic Pancreatitis - Complications

Answer 4

Diabetes 
Pancreatic carcinoma
Local Arterial aneurysm 
Splenic vein thrombosis
Gastric varices

Question 5

Chronic Pancreatitis - Symptoms

Answer 5

Abdominal pain which radiates to back. Exacerbated by food ad alcohol. Relieved by sitting forward or by hot water bottle on back or abdomen.
Severity decreases with time.
Weight loss, Steatorrhoea - due to exocrine insufficiency, Bloating, Diabetes - due to endocrine insufficiency.

Question 6

Chronic Pancreatitis - Miscellaneous features:

Answer 6

jaundice, GI haemorrhage, portal hypertension.

Question 7

Chronic Pancreatitis - Investigations

Answer 7

Abdominal Ultrasound, CXR, CT, AXR, ERCP, Bloods - amylase, FBC, U&E, LFTs, Calcium, Glucose, Serum Lipase, Lipids.

Question 8

Chronic Pancreatitis - Treatment

Answer 8

PAIN CONTROL:
avoid alcohol, low fat diet, pancreatic enzyme supplements - Creon, Pancrex, Opiate Analgesia, Coeliac Plexus Block, Endoscopc treatment of pancreatic duct stones and strictures.
MANAGEMENT EXO/ENDOCRINE INSUFFICENCY: low fat diet, pancreatic enzyme supplements, insulin for diabetic patients
ANALGESIA
SURGERY: pancreatectomy or pancreaticojeunostomy