Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • RUQ or epigastric pain (lasting >30 minutes)

Other diagnostic factors

  • postprandial pain
  • RUQ or epigastric tenderness
  • nausea
  • jaundice

Risk factors

  • increasing age
  • female gender
  • Hispanic and Native American ethnicity
  • FHx of gallstones
  • gene mutations
  • pregnancy/exogenous estrogen
  • obesity and the metabolic syndrome
  • prolonged fasting/rapid weight loss
  • total parenteral nutrition (TPN)
  • octreotide
  • incretin-based drugs
  • ceftriaxone
  • terminal ileum disease or resection
  • hemoglobinopathy
  • diabetes and the metabolic syndrome
  • low-fiber diet

Diagnostic investigations

1st investigations to order

  • CBC
  • serum LFTs
  • serum lipase and amylase
  • abdominal ultrasound
Full details

Investigations to consider

  • magnetic resonance cholangiopancreatography (MRCP)
  • endoscopic ultrasound scan (EUS)
  • endoscopic retrograde cholangiopancreatography (ERCP)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Division of Gastroenterology

University of Calgary

Calgary

Canada

Disclosures

ES declares that he has no competing interests.

Professor Eldon Shaffer would like to gratefully acknowledge Dr Vikesh K. Singh and Dr Anthony N. Kalloo, previous contributors to this monograph. VKS and ANK declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Director of Pancreatic Disorders

Section of Gastroenterology

Dartmouth-Hitchcock Medical Center

Lebanon

NH

Disclosures

TBG declares that he has no competing interests.

Professor of Hepatobiliary Surgery

Manchester Royal Infirmary

Manchester

UK

Disclosures

AS declares that he has no competing interests.

Clinical Research Fellow

Hepatopancreatobiliary and Liver Transplant Surgery

University Department of Surgery

Royal Free Campus

UCL Medical School

London

UK

Disclosures

KG declares that he has no competing interests.

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