Chronic pancreatitis

Question 1

What are the the clinical features of chronic pancreatits?

Answer 1

A deep boring pain that radiates to the back
Relieved by sitting forward of hot water bottles on back
Signs - bloating, steatorrhoea (fatty), reduced weight

Question 2

What are the causes of chronic pancreatitis?

Answer 2

Alcohol, autoimmune, cystic fibrosis, obstruction (stone or tumour), haemochromatosis

Question 3

What tests are done for chronic pancreatitis?

Answer 3

Ultrasound with or without CT
MRCP
AXR
This shows calcification of the pancreas
Fascal elastase will be increased

Question 4

What is the treatment for chronic pancreatitis?

Answer 4

Give analgesia and lipase to allow fat digestion
Fat soluable vitamins
Diet - no alcohol, low fat
Surgery - for unremitting pain then can have pancreatectomy or pancreaticojejunostomy