Chronic pancreatitis is a low grade inflammatory disease of the pancreas. It can occur after an attack of acute pancreatitis or can present on its own. Some patients are best under the Surgical team and some under Gastro/Medical teams

Causes:

• Chronic Alcohol Misuse (7/10 patients)
• Less common
  • Smoking
  • Autoimmune
  • Genetic
  • Tumour
  • Stones

Symptoms:

• Severe Upper Abdominal pain – may be constant.
• Nausea/Vomiting
• Steatorrhea – pale oily stools
• Diabetes Mellitus

Investigations:

• Amylase – may be normal or only moderately raised
• Lipase – is helpful in deterring referral route
• CT/MRI – are useful but this is not likely required from the ED

Management:

• Analgesia
• Antiemetics
• IV fluid
• Referral
  • Surgical: Lipase >400 OR Formal diagnosis of chronic pancreatitis
  • Gastro/Medical: Neither of above

A surgical opinion may be required if uncertain prior to medical admission.