https://wikem.org/w/index.php?action=history&feed=atom&title=Chronic_pancreatitis%2FenChronic pancreatitis/en - Revision history2026-05-05T15:04:09ZRevision history for this page on the wikiMediaWiki 1.38.2https://wikem.org/w/index.php?title=Chronic_pancreatitis/en&diff=380862&oldid=prevFuzzyBot: Updating to match new version of source page2026-01-07T13:11:41Z<p>Updating to match new version of source page</p>
<p><b>New page</b></p><div><languages/><br />
<br />
==Background==<br />
<br />
[[File:Blausen 0699 PancreasAnatomy2.png|thumb|Pancreatic anatomy]]<br />
*Chronic imflammatory changes of the pancreas causing permanent structural damage<br />
*Can be minimally symptomatic and presents with acute exacerbations.<br />
*Can lead to both long term endocrine and exocrine dysfunction<br />
<br />
<br />
==Clinical Features<ref>Braganza, J. M., Lee, S. H., McCloy, R. F., & McMahon, M. J. (2011). Chronic pancreatitis. Lancet, 377(9772), 1184–1197. doi:10.1016/S0140-6736(10)61852-1</ref><ref>Steer, M. L., Waxman, I., & Freedman, S. (1995). Chronic pancreatitis. New England Journal of Medicine, 332(22), 1482–1490. doi:10.1056/NEJM199506013322206</ref>==<br />
<br />
*[[Special:MyLanguage/Abdominal pain|Pain]]<br />
**Episodic (1wk) or constant<br />
**Epigastric, radiating to back and left infrascapular region<br />
**Associated with nausea/vomiting<br />
**Improved with sitting up or leaning forward<br />
*Steatorrhea/[[Special:MyLanguage/DM|DM]]<br />
**Late finding<br />
**Requires >80-90% loss of exocrine and endocrine function<br />
*Erythema ab igne<br />
**Hyperpigmentation of upper abdomen<br />
<br />
<br />
==Differential Diagnosis==<br />
<br />
{{Abdominal Pain DDX Epigastric}}<br />
<br />
<br />
==Evaluation==<br />
<br />
*Labs<br />
**Lipase: Normal or slightly elevated<br />
**[[Special:MyLanguage/LFTs|LFTs]]: Increased [[Special:MyLanguage/Hyperbilirubinemia|bilirubin]], alkaline phosphatase: Associated with compression of intrapancreatic bile duct (10-15%)<br />
**Pancreatic function tests: Secretin stimulation<br />
**Gamma-globulin IgG elevation (IgG4) in autoimmune<br />
*Imaging<ref>Choueiri, N. E., Balci, N. C., Alkaade, S., & Burton, F. R. (2010). Advanced imaging of chronic pancreatitis. Current gastroenterology reports, 12(2), 114–120. doi:10.1007/s11894-010-0093-4</ref><ref>Remer, E. M., & Baker, M. E. (2002). Imaging of chronic pancreatitis. Radiologic clinics of North America, 40(6), 1229–42– v.</ref><br />
**[[Special:MyLanguage/Abd xray|Plain film]]: pancreatic calcifications (30%)<br />
**CT: intraductal calcifications (insensitive for early disease)<br />
**ERCP: gold standard <br />
<br />
<br />
==Management==<br />
<br />
*Lifestyle modifications (alcohol and tobacco cessation), dietary changes<br />
*Pancreatic enzyme supplements<br />
*Acid suppression ([[Special:MyLanguage/H2 antagonist|H2 antagonist]], [[Special:MyLanguage/PPI|PPI]])<br />
*[[Special:MyLanguage/analgesia|Analgesics]] ([[Special:MyLanguage/NSAIDs|NSAIDs]], [[Special:MyLanguage/opioids|opioids]], [[Special:MyLanguage/pregabalin|pregabalin]])<br />
*Specialist referral for refractory pain<br />
<br />
<br />
==Disposition==<br />
<br />
<br />
==See Also==<br />
<br />
*[[Special:MyLanguage/Pancreatitis|Pancreatitis]]<br />
*[[Special:MyLanguage/Pancreatitis Guidelines|Pancreatitis Guidelines]]<br />
<br />
<br />
==External Links==<br />
<br />
<br />
==References==<br />
<br />
<references/><br />
<br />
[[Category:GI]]</div>FuzzyBot