pancreatic insufficiency

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Causes of pancreatic insufficiency in a child include:

  • cystic fibrosis
  • Shwachmann-Diamond syndrome

Causes in an adult include:

  • pancreatic exocrine dysfunction
    • chronic pancreatitis
    • pancreatectomy
  • total gastrectomy

  • pancreatic insufficiency in a child leads to malabsorption and failure to thrive:
    • symptoms include:
      • loose, odorous, and frequent stools
      • abdominal pain

  • in an adult:
    • chronic pancreatitis leads to destruction of both exocrine and endocrine tissue - in severe cases the classic triad of diabetes, malabsorption and calcification may be seen; the presenting symptoms are often weight loss and abdominal pain
    • in severe pancreatic insufficiency the patient may complain of bulky, foul smelling stools that stick to the toilet pan; passing grease or oil per rectum is a rare pathognomic sign of pancreatic insufficiency

  • management
    • depends on cause
    • pancreatin

Last reviewed 01/2018