Chronic Pancreatitis

There are several causes of chronic pancreatitis. The main causes are following:

• Excess alcohol intake is the commonest cause .
• Idiopathic
• Tropical pancreatitis
• Hypercalcemia
• Hypertriglyceridemia
• Hereditary
• Repeated attack of acute pancreatitis
• Pancreatic duct stricture/Congenital abnormality (pancreatic divisum)
• Autoimmune pancreatitis

Symptoms

• Pain is the most disabling symptom
• Diabetes, about 30% of the chronic pancreatitis patient develop diabetes
• Loose, greasy stool
• Jaundice, if it invoives the lower end of the bile duct
• Weight loss can occur
• Compression of the duodenum can lead to vomiting
• Bleeding into the gut can sometimes be the first symptom

Test

• Blood test to see if you have already develop diabetes or not.
• Pancreatic enzyme assessment is not rotuiely done in clinical practice.
• CT scan / MRCP is done to look at the pancreatic structural changes and diagnose chronic pancreatitis.
• EUS (endo ultrasound) some is done to diagnose chronic pancreatitis.

• Pain relief: all patient are given pain killers initially to control the pain but if it still continue to affect them, surgical intervention can cure pain upto 90% of the patient.
• Diabetes : medical management
• Pancreatic enzyme deficiency: Pancreatic enzymes to be taken at the time of meals

• Intractable pain
• Pancreatic duct stenosis (narrowing)
• Cysts and pseudocysts
• Biliary obstruction
• Duodenal obstruction
• Suspicion of cancer
• Portal or splenic vein thrombosis