By Prof. Dr. med. P. G. Lankisch, Prof. Dr. med. M. Büchler, Prof. Dr. med. J. Mössner, Prof. Dr. S. Müller-Lissner (auth.)
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In addition, extrapancreatic complications such as bile duct dilatation, portal or splenic dilatation and ascites can be imaged. Indication Abdominal ultrasound is a basic diagnostic procedure when chronic pancreatitis is suspected. Sensitivity Early stages of the disease usually cannot be diagnosed. L_ Sp leni vein Superior mesenteric artery AOl1a Stone in the dilated pancreatic duct _~_ < - Liver Pancreas Aorta Several pancreatic pseudocysts Liver Pan reatic duct Splenic vein Pseudocyst Cyst of the head of the pancreas, with dilated pancreatic duct 47 Chronic pancreatitis Abdominal computed tomography Findings These are the same as for ultrasound.
Distension, flatulence The dietary constituents which reach the colon are metabolized by bacteria, which leads to the formation of gas. Distension and flatulence may precede diarrhoea in the course of chronic pancreatitis. Weight loss This may be due to exocrine insufficiency or to reduced food intake due to fear of pain. Jaundice This can arise as a result of bile duct stenosis in an acute episode of chronic pancreatitis. When the inflammation fades, it may regress spontaneously. ,_v_o_m_it_in.
Episodes of pain may be triggered by alcohol abuse and/or large, fatty meals. Only 5-10 % of cases of chronic pancreatitis have a primarily painless course. Diarrhoea, steatorrhoea The reduced or absent enzyme secretion leads to impaired cleavage of dietary constituents. This leads to osmotic diarrhoea which, if the fat content is high, is called steatorrhoea. Distension, flatulence The dietary constituents which reach the colon are metabolized by bacteria, which leads to the formation of gas. Distension and flatulence may precede diarrhoea in the course of chronic pancreatitis.