Chronic pancreatitis
| Chronic pancreatitis | |
| ICD-10 | K86.0-K86.1 |
|---|---|
| ICD-9 | 577.1 |
| OMIM | 167800 |
| DiseasesDB | 9559 |
| MedlinePlus | 000221 |
| eMedicine | med/1721 |
| MeSH | D050500 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Chronic pancreatitis is a long-standing inflammation of the pancreas that alters its normal structure and functions. It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption.
Causes
At least 70% of adult cases are caused by chronic alcohol use, and most patients have consumed more than 150 g/day of alcohol over six to twelve years.[1] Gallstone-associated pancreatitis is predominantly acute or relapsing-acute in nature, and some cases of chronic pancreatitis are of undetermined or idiopathic origin. A few are inherited or secondary to Sphincter of Oddi dysfunction (SOD). Other less frequent causes include chronic steroid and or anti-inflammatory use. In up to one quarter of cases, no cause can be found. Autoimmune pancreatitis is increasingly recognized and may be associated with raised IgG4 levels, other autoimmune features and bile duct involvement.
Cystic fibrosis is the most common cause of chronic pancreatitis in children. In other parts of the world, severe protein-energy malnutrition is a common cause.
Symptoms
Patients with chronic pancreatitis usually present with persistent abdominal pain or steatorrhea resulting from malabsorption of the fats in food (typically very bad-smelling and equally hard on the patient), as well as severe nausea. Diabetes is a common complication due to the chronic pancreatic damage and may require treatment with insulin. Some patients with chronic pancreatitis often look very sick, while others don't appear to be unhealthy at all.
Considerable weight loss, due to malabsorption, is evident in a high percentage of patients, and can continue to be a health problem as the condition progresses. The patient may also complain about pain related to their food intake, especially those meals containing a high percentage of fats and protein.
References
- ↑ Nair RJ, Lawler L, Miller MR (2007). "Chronic pancreatitis". Am Fam Physician. 76 (11): 1679–88. PMID 18092710.