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chronic pancreatitis

CHRONIC rubor 

chronic rubor is progressive,irreversible inflamation of exocrine gland defined by higher abdominal pain that is unhealthful and as illness progress exocrine  insufficiency manifest by weight loss and steatorrhoea and endocrine insufficiency manifest by DM. ETIOLOGY OF CHRONIC rubor one.CHRONIC CALCIFYING PANCREATITIS- ALCOHOL is major cause  - NUETRITIONAL causes particularly in tropical Africa and asia - HERIDATORY  causes -IDIOPATHIC. rubor a pair of.CHRONIC hindering rubor owing to -tumors of ampulla and exocrine gland -cystic lesions  -pancreatic duct injury owing to acute rubor,trauma -ampullary stricture or associated hernia -cholelithiasis typically cause acute rubor however some patient have chronic illness CLINICAL options one.SEVERE EPISODIC higher ABDOMINAL PAIN -severe episodic epigastric pain that radiates to back -it last for hours or days -may be eased by bending forwards or by forcing out -it typically precipited by giant meal or by drinking alcohol

2.WEIGHT LOSS -weight loss owing to exocrine gland operate failure (steatorrhoea and polygenic disease mellitus) three.OBSTRUCTIVE JAUNDICE -May result from common channel compression by inflamed head of exocrine gland four.COMPLICATION OF THE illness could also be presenting feature eg epigastric mass from pseudocyst formation five. Some patient with acute rubor ar diagnosed incidentaly at section or aftet finding of exocrine gland calcification INVESTIGATION 

1.X-ray of abdomen could show exocrine gland calcification a pair of.ultrasonography of abdomen -Show chages in exocrine gland size,shape.echotexture and calcification-endoscopic tomography permit elaborate investigation of inauspicious case and demostrate little caliculi not seen by canventional ultrasound three.Endoscopic retograde choliangiopancreatography -it is gold customary Investigation that demostrates stricture or disruption of epithelial duct .choliangiography show choledocolithiasis and body part or common channel stenosi Multiple calcification of pncreas seen in ct of chronic rubor patient four.Megnetic resonance cholangiopancreatography -it provides informatio regarding ductal and body structure and performance -uses embrace analysis of tumors and cystic lesion.follow of pseudocystes and stents once ercp has did not valuate five.Biochamical Investigation 

-there is not any relaible organic chemistry take a look at for chronic rubor as bodily fluid enzyme ,isoamylase ,trypsin ANd enzyme level could also be elevated throughout an exacerbation however ar typically traditional. 6.tubeless exocrine gland operate tests -indirectly assess exocrine  finction from urinary recovery of a matter created by protein specific cleavage of AN orally administered substrate. 7.pancreatic diagnostic test -percutaneous ultrasound-guided or ct -guided diagnostic test victimization machine-driven device (biopsy gun) is safe and reliable technique to work out the character of exocrine gland mass lesions and in whom there\'s a powerful suspicion of chronic rubor if alternative Investigation haven\'t helped.

MANAGMENt

1.PAIN management -NONSTEROIDAL ANALGESIC ar most popular however most patient with severe pain reqiire oral NARCOTIC ANALGESIC a pair of.ABSTINENCE  FROM  ALCOHOL three.STEATORRHOEA management -pancreatic protein supplements enteric coated-few patient conjointly needed h2 receptor antagonists - dietory fat restriction four.DIABETES management -Control by victimization diet or oral symptom agents five.THERAPEUTIC  ERC - it\'s needed in common channel spincterotomy and stone clearance.-pancreatic duct stenting offer initial pain relief vi.SURGERy -resection or drain for stubborn pain -distal surgical operation if localised distal illness -drainage procedure if main duct is expanded seven.ANTIOXIDANT medical care -micronuetrient supplementation with atomic number 34,methionine,and vitamin A,C and E if proof suggests that aerobic  stress is a crucial consider pathological process of rubor, no matter etiology.

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