Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- abdominal pain
- steatorrhoea
- 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
- coeliac disease
- psoriasis
- high-fat, high-protein diet
- tropical geography
Diagnostic investigations
1st investigations to order
- blood glucose
- CT scan
- abdominal ultrasound
- abdominal x-ray
Investigations to consider
- endoscopic ultrasound (EUS)
- endoscopic retrograde cholangiopancreatography (ERCP)
- magnetic resonance cholangiopancreatography (MRCP)
- faecal elastase-1
- faecal fat
- steatocrit
- direct pancreatic function tests
- genetic screening
- biopsy
- IgG4 levels
- therapeutic trial of corticosteroids
Treatment algorithm
Contributors
Authors
Associate Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Michigan School of Medicine
Ann Arbor
MI
Disclosures
MJD receives grant support from National Institutes of Health. MJD has consulted for or received honoraria from American Gastroenterological Association (AGA), Oakstone Publishing, and Cystic Fibrosis Foundation. MJD sits on committees, advisory boards, and/or editorial boards for AGA Institute, National Pancreas Foundation Michigan Chapter, Faculty of 1000 Research, Pancreatology, the Pancreapedia, and Pancreas.
Associate 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
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 topic.
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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