Pancreatite crônica
Summary
定义
病史和体格检查
关键诊断因素
- presença de fatores de risco
- dor abdominal
- esteatorreia
- icterícia
其他诊断因素
- perda de peso e desnutrição
- diabetes mellitus/intolerância à glicose
- náuseas e vômitos
- distensão abdominal e/ou flatulência excessiva
- nódulos cutâneos
- dor nas articulações
- fratura por baixo impacto
- distensão abdominal
- dispneia
危险因素
- bebidas alcoólicas
- tabagismo
- história familiar
- doença celíaca
- psoríase
- dieta com alto teor de gordura e proteína
- geografia tropical
诊断性检查
首要检查
- tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM)
- ultrassonografia endoscópica (USE)
- colangiopancreatografia por ressonância magnética com contraste de secretina (CPRM-s)
需考虑的检查
- exame histológico
- teste genético
- teste indireto da função pancreática (elastase-1 fecal)
- gordura fecal
- esteatócrito
- testes diretos da função pancreática
- níveis de IgG4
- tentativa terapêutica com corticosteroides
治疗流程
dor aguda episódica intermitente
controle da dor persistente
撰稿人
作者
Matthew J. DiMagno, MD
Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Michigan School of Medicine
Ann Arbor
MI
利益声明
MJD sits on committees, advisory boards, and/or editorial boards for the National Pancreas Foundation Michigan Chapter, Faculty of 1000 Research, Pancreatology, the Pancreapedia, and Pancreas. MJD has been a speaker for AGA Invited Speaker Symposium and NPF and Michigan Medicine 7th Annual Patient and Family Centered Care for Pancreatic Diseases.
Erik-Jan Wamsteker, MD
Associate Professor of Internal Medicine
Division of Gastroenterology and Hepatology
University of Michigan School of Medicine
Ann Arbor
MI
利益声明
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
利益声明
AL has consulted for GSK and Atmo Biosciences.
同行评议者
Christopher Forsmark, MD
Professor of Medicine
Chief
Division of Gastroenterology, Hepatology, and Nutrition
University of Florida
Gainesville
FL
利益声明
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
利益声明
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.
参考文献
关键文献
Dominguez-Munoz JE, Drewes AM, Lindkvist B, et al. Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis. Pancreatology. 2018 Dec;18(8):847-54. 摘要
Whitcomb DC, Buchner AM, Forsmark CE. AGA clinical practice update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency: expert review. Gastroenterology. 2023 Nov;165(5):1292-301.全文 摘要
Gardner TB, Adler DG, Forsmark CE, et al. ACG clinical guideline: chronic pancreatitis. Am J Gastroenterol. 2020 Mar;115(3):322-39. 摘要
ASGE Standards of Practice Committee, Sheth SG, Machicado JD, et al. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of chronic pancreatitis: summary and recommendations. Gastrointest Endosc. 2024 Oct;100(4):584-94.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Câncer de pâncreas
- Pancreatite aguda
- Cólica biliar
更多 鉴别诊断指南
- American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of chronic pancreatitis
- Chronic pancreatitis
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