Chronic Pancreatitis Definition: A pathologic fibroinflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathologic responses to parenchymal injury or stress. 60% of CP cases evolved from acute pancreatitis and recurrent acute pancreatitis (RAP), whereas about 10% of acute pancreatitis and 30% of RAP progress to CP Etiology of CP - TIGAR-O system: • T (Toxic-Metabolic) • I (Idiopathic) • G (Genetic) • A (Autoimmune) • R (Recurrent acute or severe pancreatitis) • O (Obstructive) Diagnosis: • 1st line: CT or MRI • 2nd line: EUS only if diagnosis is in question after cross-sectional imaging • 3rd line: secretin-enhanced MRCP if diagnosis in question after cross-sectional imaging or EUS • 4th line: histologic diagnosis with EUS-guided FNA (low sensitivity) Clinical Manifestations: • Abdominal pain • Fat-soluble vitamin deficiency -> malnutrition/osteoporosis • Risk of pancreatic malignancy • Endocrine insufficiency manifesting as DM By Amneet Hans, MD @amneethansmd via @EmoryGastroHep #Chronic #Pancreatitis #diagnosis #management #gastroenterology #treatment
