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Chronic pancreatitis

Chronic pancreatitis

Chronic pancreatitis is a serious pancreatic inflammation emerged with severe pain in the upper abdomen. It is due to long-term use of alcohol, as well as trauma, cystic fibrosis, drugs, high calcium levels in the blood, or any condition arising from heredity or birth. It also occurs after various inflammatory pancreatic attacks which damage the pancreas.Chronic pancreatitis is a serious, life-threatening condition requiring urgent medical attention.

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Upper abdominal CT scan showing numerous white calcifications. These occur in chronic pancreatitis.

Symptoms of chronic pancreatitis

Most cases of chronic pancreatitis (about 70%) are due to long-term alcohol intake. Chronic pancreatitis is more commonly observed in men than in women, generally, it occurs at the age of 30-40. Symptoms associated with this disease, acute abdominal pain in the upper part of the abdomen is similar to the inflammatory pancreatitis. Pain is usually worse when lying down, but it may be felt less intense when sitting or bending. Other symptoms include:

  • Nausea
  • Vomiting
  • Fever
  • Increased pulse
  • The pain spreading from the abdomen to the back or to the chest
  • Abdominal sensitivity
  • Swelling
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Severe complications

Intensive pain associated with chronic pancreatitis is that normal digestive enzymes flowing to the small intestine remain in the pancreas and attack the pancreas. Pancreatitis also affects the pancreas's ability to release insulin, which is necessary to regulate glucose levels. Therefore, this disease may lead to permanent diabetes. In a worse scenario, pancreatic tissue may die and be infected (pancreatic necrosis or abscess).

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Diagnosing chronic pancreatitis

Your doctor may suspect chronic pancreatitis due to your history of disease and symptoms. The same tests and procedures used in the diagnosis of inflammatory pancreatitis are also used to diagnose chronic pancreatitis.

Blood tests

The levels of abnormal pancreatic enzymes that help digestion - amylase and lipase can be tested.

Abdominal ultrasonography

To obtain these images, sound waves are used more than X-rays. Images may indicate the presence of obstruction in the bile duct. During this procedure, the USE probe is put on the abdomen and the images are transferred to the computer.

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Abdominal CT or MRI

Abdominal CT examination or MRI may confirm the presence of obstruction in the bile duct. Both examinations are non-invasive procedures that reflect the bile duct images on the computer monitor.

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Endoscopic Examination and ERCP

Endoscopic retrograde cholangiopancreatography or ERCP is a special endoscopic method used to study gall bladder, pancreas and bile ducts and is a treating tool. EDCP is used for more than 30 years and is accepted as a standard method for the diagnosis and treatment of gall bladder diseases. During ERCP, along with a light anaesthetic substance, the patients are given anaesthesia for numbing the throat. Afterwards, your gastroenterologist enters the stomach and intestine through the mouth with an endoscope with a mobile camera anaesthesia. When your gastroenterologist sees the gall - bladder and pancreas ducts on the monitor, he\she enters a fine USE probe through ERCP. Light wave signals are used instead of x-rays for better viewing the bile and pancreatic ducts through the endoscopic USE. Special preparations are necessary for the endoscopic intervention.

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Magnetic Resonance Collagenopancreaticography (MRCP)

This non-invasive diagnostic method is performed in radiology using MRI technology (magnets and radio waves) to produce computer images of bile ducts. Inject the contrast dye before the abdominal skin to enhance the pictures. Patients do not need to be prepared for endoscopy and are not subject to sedation. MRCP is especially used in patients who have failed or are not good candidates for ERCP, who don’t want to be undergone to an endoscopic procedure and who are at low risk of pancreatic duct or bile duct dysfunction. While ERCP allows treatment options with colonoscopy, MRCP is only a diagnostic tool.

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Click here to get information regarding treatment of chronic pancreatitis

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