<aside> 💡 Persistent inflammation of the pancreas causing irreversible pancreatic parenchymal loss, fibrosis and possible calculus formation. Causes a gradual loss of exocrine (digestive enzymes) and endocrine (insulin and glucagon) functioning

Recurrent acute pancreatitis → fibrosis, exocrine atrophy with cystic dilated ducts, calcification.

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Aetiology

• Autoimmune - usually immunoglobulin G4 (IgG4) related disease
• Alcoholism
• Acute pancreatitis
• Genetic mutations - eg. cystic fibrosis
• Chronic pancreatic duct or common bile duct obstruction

Clinical Features

• Epigastric pain radiating to back lasting hours
  • May be linked to meals
• Weight loss
• Nausea/vomiting/diarrhoea
• Loss of pancreatic function
• Deficiency in vitamins A, D, E & K
• Decreased albumin (nail signs)
  • Pleural effusion
• Steatorrhea - greasy, smelly stools

Investigations