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慢性胰腺炎

最后审阅: 1 Nov 2024
最后更新: 10 Aug 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 腹痛
  • 脂肪痢
  • 黄疸
完整详情

其他诊断因素

  • 体重减轻和营养不良
  • 糖尿病/葡萄糖耐受不良
  • 恶心和呕吐
  • 皮肤结节
  • 关节痛
  • 低创伤性骨折
  • 腹胀
  • 呼吸短促
完整详情

危险因素

  • 酒精
  • 吸烟
  • 家族史
  • 乳糜泻
  • 银屑病
  • 高脂、高蛋白饮食
  • 热带地区
完整详情

诊断性检查

首要检查

  • 计算机体层成像(CT)或磁共振成像(MRI)
  • 超声内镜 (EUS)
  • 促胰液素增强磁共振胰胆管造影(s-MRCP)
完整详情

需考虑的检查

  • 组织学检查
  • 基因检测
  • 间接胰腺功能检查(粪便弹性蛋白酶-1)
  • 粪便脂肪
  • 粪脂测定(steatocrit)
  • 直接胰腺功能试验
  • IgG4水平
  • 皮质类固醇试验性治疗
完整详情

治疗流程

急症处理

急性间歇性疼痛发作

持续性治疗

持续性疼痛的管理

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 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

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 received grant funding from the National Institutes of Health.

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.

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