One of the articles currently available on OnlineFirst is by Dr Joseph Fiske on the subject of Chronic Pancreatitis.
Making a diagnosis of chronic pancreatitis can be extremely difficult. The first step is to remember to consider it for an abdominal pain which perhaps isn’t fitting other clinical pictures. It is much less common than other causes of recurrent epigastric pain such as peptic ulcer disease or biliary colic but unlike acute pancreatitis, there is no reliable blood test to identify it. Often an abdominal ultrasound would be a next step, primary care investigation to check for gallstones and this may indeed indicate the changes seen in the pancreas.
If imaging is inconclusive, faecal elastase can be used but ultimately this condition is likely to be actually diagnosed in secondary care. It is important to remember if acute pancreatitis is suspected that referral should be for same day admission.
Management of chronic pancreatitis is complex – the most difficult aspect can be pain control. It has a high level of morbidity and mortality as there are several complications which can occur, most notably pancreatic cancer.
To read more about chronic pancreatitis, such as the typical presenting features and its management access the article from OnlineFirst.