Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presencia de factores de riesgo
- dolor abdominal
- esteatorrea
- ictericia
Otros factores de diagnóstico
- pérdida de peso y desnutrición
- diabetes mellitus/intolerancia a la glucosa
- náuseas y vómitos
- hinchazón y/o flatulencia excesiva
- nódulos cutáneos
- dolor en las articulaciones
- fractura por traumatismo leve
- distensión abdominal
- disnea
Factores de riesgo
- alcohol
- tabaquismo
- antecedentes familiares
- enfermedad celíaca
- psoriasis
- dieta de alto contenido en grasas y proteínas
- geografía tropical
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- tomografía computarizada (TC) o resonancia magnética (RM)
- ecoendoscopia
- colangiopancreatografía por resonancia magnética con secretina (CPRM-S)
Pruebas diagnósticas que deben considerarse
- examen histológico
- pruebas genéticas
- pruebas indirectas de función pancreática (elastasa fecal-1)
- grasa fecal
- esteatocrito
- pruebas directas de función pancreática
- niveles de inmunoglobulina G4 (IgG4)
- protocolo terapéutico de corticosteroides
Algoritmo de tratamiento
dolor agudo intermitente episódico
manejo del dolor persistente
Colaboradores
Autores
Matthew J. DiMagno, MD
Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Michigan School of Medicine
Ann Arbor
MI
Divulgaciones
MJD has received grant support from National Institutes of Health. MJD has received honoraria and/or royalties from Oakstone Publishing and William M. Steinberg Board Review in Gastroenterology and Best Practices Course for publications and presentations related to pancreatic disorders. He has consulted for AbbVie, Chiesi, Nestlé, and Vivus. MJD sits on committees, advisory boards, and/or editorial boards for the AGA Institute, National Pancreas Foundation Michigan Chapter, Faculty of 1000 Research, Pancreatology, the Pancreapedia, and Pancreas.
Erik-Jan Wamsteker, MD
Associate Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Michigan School of Medicine
Ann Arbor
MI
Divulgaciones
EJW declares that he has no competing interests.
Allen Lee, MD
Assistant Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Vermont College of Medicine
Burlington
VT
Divulgaciones
AL has received grant funding from the National Institutes of Health.
Revisores por pares
Christopher Forsmark, MD
Professor of Medicine
Chief
Division of Gastroenterology, Hepatology, and Nutrition
University of Florida
Gainesville
FL
Divulgaciones
CF is an author of a number of references cited in this topic.
Jakob R. Izbicki, MD, FACS
Chairman, Surgeon in Chief
Department of General, Visceral and Thoracic Surgery
University Hospital Hamburg-Eppendorf
Hamburg
Germany
Divulgaciones
JRI declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Sherman S, Freeman ML, Tarnasky PR, et al. Administration of secretin (RG1068) increases the sensitivity of detection of duct abnormalities by magnetic resonance cholangiopancreatography in patients with pancreatitis. Gastroenterology. 2014;147:646-54.e2.Texto completo Resumen
Gurusamy KS, Lusuku C, Davidson BR. Pregabalin for decreasing pancreatic pain in chronic pancreatitis. Cochrane Database Syst Rev. 2016;(2):CD011522.Texto completo Resumen
Ahmed Ali U, Jens S, Busch OR, et al. Antioxidants for pain in chronic pancreatitis. Cochrane Database Syst Rev. 2014 Aug 21;(8):CD008945.Texto completo Resumen
Ahmed Ali U, Pahlplatz JM, Nealon WH, et al. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis. Cochrane Database Syst Rev. 2015 Mar 19;(3):CD007884.Texto completo Resumen
Gurusamy KS, Lusuku C, Halkias C, et al. Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis. Cochrane Database Syst Rev. 2016 Feb 3;(2):CD011521.Texto completo Resumen
Bachmann K, Tomkoetter L, Erbes J, et al. Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up. J Am Coll Surg. 2014 Aug;219(2):208-16. Resumen
Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med. 2007;356:676-84. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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