China
Africa
Explore chapters and articles related to this topic
Pancreatitis—Chronic
Published in Charles Theisler, Adjuvant Medical Care, 2023
Chronic pancreatitis is characterized by permanent and progressive structural or functional damage of the pancreas with scarring (fibrosis). This results in exocrine and endocrine insufficiency and, often, chronic disabling pain. The symptoms are identical to acute pancreatitis. Most patients with chronic pancreatitis are alcoholics. Symptoms of chronic pancreatitis can include abdominal pain, malabsorption, bleeding due to anemia, liver problems leading to jaundice, weight loss, nutritional deficiencies, and an inability to produce insulin, resulting in diabetes.1
Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Causes of chronic pancreatitis are: Alcohol (over 60% of cases)HyperlipidaemiaMalnutritionCystic fibrosisHypercalcaemiaHereditary (autosomal dominant)Idiopathic causesGenetic risk factors, including variants in cationic trypsinogen (PRSS1), serine protease inhibitor Kazal-type 1 (SPINK1) and carboxypeptidase A1 (CPA1)Autoimmunity
HPB Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
London Lucien Ooi Peng Jin, Teo Jin Yao
What features do you expect to see on imaging?Patients have often undergone multiple imaging as well as therapeutic modalities by the time the diagnosis of chronic pancreatitis is confirmed.Typical findings on cross-sectional imaging include parenchymal calcifications, pancreatic ductal stones, biliary and pancreatic duct strictures.MRCP evaluates the extent of ductal dilation and location of ductal strictures more accurately.CT visualises parenchymal calcification better.Patients with chronic or ‘burnt out’ disease may have an atrophic pancreas.There may be features of complications of CP – pseudocysts, pseudoaneurysms, splenic vein thrombosis, splenomegaly, varices.
Inherited causes of exocrine pancreatic insufficiency in pediatric patients: clinical presentation and laboratory testing
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Tatiana N. Yuzyuk, Heather A. Nelson, Lisa M. Johnson
Imaging studies progress from least invasive to more invasive to evaluate patients with acute, recurrent pancreatitis [48]. Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) are noninvasive cross-sectional imaging techniques used for initial evaluation. More invasive endoscopic procedures may be considered if the CT or MRCP has equivocal or mild findings. When HP is suspected, mutational analysis of the genes PRSS1, SPINK1, CFTR, and CTRC is warranted. A patient meets the criteria necessary for genetic testing of pancreatitis-related gene variants if they satisfy one or more of the following criteria: (1) acute or recurrent pancreatitis in a child with an unknown cause, (2) idiopathic chronic pancreatitis in a patient less than 25 years old, (3) family history of acute recurrent pancreatitis or idiopathic chronic pancreatitis, or (4) relatives with known HP-related gene mutations [49].
Should we be reluctant to perform pancreatectomy in patients with chronic liver disease? A single center 10-year experience
Published in Acta Chirurgica Belgica, 2023
Woo-Hyoung Kang, Young-Dong Yu, Kyung-chul Yoon, Hye-Sung Jo, Dong-Sik Kim
Mariette et al. reported in detail the overall prevalence of pancreatic surgery in CLD. A total of 35 patients were included; 17 underwent surgery for chronic pancreatitis, three for acute pancreatitis, 14 for malignant tumors, and one for a benign tumor [23]. The procedures included nine resections, including three distal pancreatectomies, two pancreaticoduodenectomies, two ampullectomies and two atypical resections for acute pancreatitis. Overall, morbidity was 51% and mortality was 20%. All three patients who had emergency procedures died. They concluded that endoscopic and radiologic treatments should be preferred in cirrhotic patients with an inflammatory disease or tumor of the pancreas and rare indications for resection should be reserved for elective procedures in Child–Pugh A patients without elevated transaminases [23].
Assessment of small intestinal bacterial overgrowth in chronic pancreatitis patients using jejunal aspirate culture and glucose hydrogen breath test
Published in Scandinavian Journal of Gastroenterology, 2021
Rajesh Sanjeevi, Kapil Dev Jamwal, Sudipta Dhar Chowdhury, Balamurugan Ramadass, R. Gayathri, Amit Kumar Dutta, Anjilivelil Joseph Joseph, Balakrishnan S. Ramakrishna, Ashok Chacko
Chronic pancreatitis is a syndrome of chronic progressive pancreatic inflammation and scarring, leading to irreversible damage of the pancreas with resultant loss of exocrine and endocrine function [1]. Pancreatic exocrine insufficiency (PEI) is an under-recognized problem amongst patients with chronic pancreatitis [2]. Destruction of pancreatic acini reduces pancreatic enzyme secretions resulting in PEI. Though lipid digestion is predominantly affected, PEI can also lead to carbohydrate and protein maldigestion [3]. PEI can lead to bloating, steatorrhoea or diarrhea and significantly impair the quality of life [4]. Changes in pancreatic exocrine function have been shown to produce changes in microbial diversity within the gastrointestinal tract [5]. One such pathological form of microbial dysbiosis that occurs in chronic pancreatitis is small intestinal bacterial overgrowth (SIBO). SIBO has been defined as a clinical syndrome caused by the presence of an excess amount of bacteria in the small bowel [6]. Symptoms of SIBO can mimic symptoms of PEI. Factors that predispose chronic pancreatitis patients to SIBO include decreased pancreatic proteolytic enzymes, use of narcotics, ethanol use, use of proton pump inhibitors (PPIs) and diabetic neuropathy [7–10].