Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • steatorrhea
  • jaundice

Other diagnostic factors

  • weight loss and malnutrition
  • nausea and vomiting
  • skin nodules
  • painful joints
  • low-trauma fracture
  • abdominal distension
  • shortness of breath

Risk factors

  • alcohol
  • smoking
  • family history
  • celiac disease
  • high-fat, high-protein diet
  • tropical geography

Diagnostic investigations

1st investigations to order

  • blood glucose
  • CT scan
  • abdominal ultrasound
  • abdominal plain film
Full details

Investigations to consider

  • endoscopic ultrasound (EUS)
  • endoscopic retrograde cholangiopancreatography (ERCP)
  • magnetic resonance cholangiopancreatography (MRCP)
  • fecal elastase-1
  • fecal fat
  • steatocrit
  • direct pancreatic function tests
  • genetic screening
  • biopsy
  • IgG4 levels
  • therapeutic trial of corticosteroids
Full details

Emerging tests

  • investigational pancreatic function tests
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Internal Medicine

Division of Gastroenterology and Hepatology

University of Michigan School of Medicine

Ann Arbor

MI

Disclosures

MJD receives grant support from University of Michigan, Cystic Fibrosis Foundation, and National Institutes of Health. MJD has consulted for or received honoraria from American Gastroenterological Association, Oakstone Publishing, Cystic Fibrosis Foundation, and American College of Physicians. MJD sits on committees, advisory boards and/or editorial boards for AGA Institute, PancreasFest, Faculty of 1000 Research, Pancreatology, the Pancreapedia, and Pancreas.

Assistant Professor of Internal Medicine

Division of Gastroenterology and Hepatology

University of Michigan School of Medicine

Ann Arbor

MI

Disclosures

EJW declares that he has no competing interests.

Assistant Professor of Internal Medicine

Division of Gastroenterology and Hepatology

University of Vermont College of Medicine

Burlington

VT

Disclosures

AL declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Chief

Division of Gastroenterology, Hepatology, and Nutrition

University of Florida

Gainesville

FL

Disclosures

CF is an author of a number of references cited in this monograph.

Chairman, Surgeon in Chief

Department of General, Visceral and Thoracic Surgery

University Hospital Hamburg-Eppendorf

Hamburg

Germany

Disclosures

JRI declares that he has no competing interests.

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