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Pathology
Chronic inflammation of the pancreas resulting in disruption of pancreatic architecture, this causes impaired endocrine and exocrine function
Aetiology
Alcohol excess is commonest, other causes are genetic, SLE, autoimmune, gallstones and idiopathic
Signs
Epigastric tenderness
Symptoms
Epigastric pain, radiating to the back, steatorrhoea, fat malabsorption, diarrhoea and diabetes
Investigations
Bloods: FBC, U&E, LFTs, Glucose, Calcium Profile, Faecal Elastase - reduced
Imaging: Abdominal X-ray shows calcification of the pancreas
CT Abdomen shows calcification of the pancreas and possible pseudocysts
Treatment
Medical: Analgesia for chronic pain, pancreatic enzyme supplements with meals for
exocrine function and insulin if patient has diabetes
Surgical: Coeliac Plexus block for analgesia and pancreaticojejunostomy
Prognosis
Good prognosis with adequate management.
Overall survival is 70% at 10 years.
Pancreatic carcinoma, fat soluble vitamin deficiency, pseudocyst formation, gastric
varices, Type 1 diabetes, aneurysm, ascites, biliary obstruction
Key Facts
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Key Images
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Key References
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