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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Severe disease may develop before symptoms are evident. In the West most patients have a history of prolonged and heavy alcohol use.

Clinical features of chronic pancreatitis may include:

  • abdominal pain - mainly epigastric and upper abdominal; may radiate to the back. The pain is variable and may be severe. It may be continuous and difficult to distinguish from that of pancreatic carcinoma; or may be episodic, often, but not always, precipitated by alcohol.
  • anorexia and weight loss - due to malabsorption and / or small meals
  • features of exocrine insufficiency:
    • steatorrhoea - occurs in about 50% of patients; can be minimal in patients who reduce their fat intake
    • hypocalcaemia - unabsorbed fat chelates calcium
    • malabsorption of fat - but malabsorption of fat soluble vitamins rarely produces symptoms such as bleeding tendency
    • protein catabolism - protein malabsorption due to deficiency of pancreatic proteases - exacerbates weight loss
  • features of endocrine insufficiency:
    • impaired glucose tolerance
    • eventually, frank diabetes
  • other features:
    • obstructive jaundice
    • portal hypertension from splenic or portal vein thrombosis
    • pancreatic duct strictures

Examination reveals epigastric tenderness; rarely, a mass.


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