Chronic pancreatitis

Question 1

causes of GI malabsorption

Answer 1

coeliac, chronic pancreatitis, Crohns.

Question 2

what is the presentation

Answer 2

epigastric pain to the back, relieved by sitting forward or hot water bottles, bloating, steatorrhea, decr weight, brittle diabetes

Question 3

causes

Answer 3

alcohol, rarely: familial, CF, haemochromatosis, pancreatic duct obstruction, incr PTH, congenital

Question 4

tests

Answer 4

ultrasound and CT- pancreatic calcifications, MRCP and ERCP risks of acute attack. AXR- speckled calcification, incr glucose, breath tests

Question 5

treatment

Answer 5

drugs- analgesia, fat soluble vitamins, insulin. diet- no alcohol, low fat may help. surgery for unremitting pain, narcotic abuse, decr weight pancreatectomy or pancreaticojejunostomy

Question 6

complications

Answer 6

pseudocyst, diabetes, biliary obstruction, aneurysm, gastric varices, pancreatic carcinoma