Chronic Pancreatitis Flashcards
Chronic pancreatitis
Irreversible pancreatic damage
Stellate cells
Have role in inflammation of both acute and chronic pancreatitis
Strong association between chronic pancreatitis and
Smoking lead to
Autodigestion
………….is the most common cause of clinically apparent chronic pancreatitis, whereas……………..is the most frequent cause in children
Alcoholism
cystic fibrosis (Mutations of CFTR)
Type 1 AIP is often associated with involvement of other organs in the setting of IgG4-related disease
Bilateral submandibular gland enlargement
Characteristic renal lesions
Retroperitoneal fibrosis
Stricturing of the suprapancreatic biliary tree( IgG4-associated cholangitis)
isolated intrahepatic bile duct strictures (type 1AIP Only)
Detected with
which can mimic primary sclerosing cholangitis
, and is referred to as IgG4-related sclerosing cholangitis
previously termed IgG4-associated cholangitis).
ERCP + MRCP
CT scan demonstration
diffuse or focal enlargement during active disease, unless the gland is atrophic due to previous disease
Patients with chronic pancreatitis respond very well to glucocorticoids
A poor response should raise suspicion of an alternate diagnosis, such as……………
pancreatic cancer
may be needed to confirm the diagnosis of exocrine pancreatic insufficiency.
fecal elastase-1 level
Modalities of diagnosis
Abdominal CT imaging is the initial modality of choice,
followed by MRI, endoscopic ultrasound, and pancreas function testing.
the diagnostic test with the best sensitivity.
is the hormone stimulation test using secretin
The secretin test becomes abnormal when≥60%of the pancreatic exocrine function has been lost.
This usually correlates well with the onset of chronic abdominal pain.
Although most patients develop hyperglycemia due to insulin deficiency but……………… are uncommon.
Likewise, end-organ damage ………………..is also uncommon.
diabetic ketoacidosis and diabetic coma
retinopathy, neuropathy, nephropathy
Nondiabetic retinopathy may be due to vitamin A and/or zinc deficiency.
Patients with………………… have an increased risk for pancreatic cancer compared to other forms of chronic pancreatitis
hereditary PRSS1 or tropical pancreatitis