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
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
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
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）
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
治疗流程
急性间歇性疼痛发作
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.
鉴别诊断
- 胰腺癌
- 急性胰腺炎
- 胆绞痛
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- 慢性胰腺炎
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