Chronic pancreatitis

Definition

Relapsing and worsening pancreatitis. Present over days, weeks, months, years.

Epidemiology

Pathophysiology

There are few things that can cause it. Usually alcohol but otherwise: familial, CF, haemachromatosis, biliary tree obstruction, hyperparathyroidism, congenital.

Clinical Features

Epigastric pain boring through to back, relieved by sitting forward or hot water bottles. Also: steatorrhoea; raised glucose; uncontrolled diabetes.

Investigations

USS, CT, AXR, MRCP/ERCP, glucose breath tests.

Management

Analgesia (possibly coeliac plexus block); lipase; diet - no alcohol, low fat; surgery - if unremitting pain, pancreatectomy/pancreaticojejunectomy.