Pancreatitis crónica

  1. Iglesias-García, J.
  2. Lariño-Noia, J.
  3. Domínguez-Muñoz, J.E.
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2020

Serie: 13

Número: 9

Páxinas: 477-487

Tipo: Artigo

DOI: 10.1016/J.MED.2020.05.020 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumo

Resumen La pancreatitis crónica es una enfermedad inflamatoria crónica del páncreas que se acompaña de fibrosis parenquimatosa y pérdida de tejido funcional, que en fases avanzadas lleva a desarrollar una insuficiencia pancreática exocrina y endocrina. Existen diferentes causas que en la actualidad se resumen en la clasificación TIGAR-O, siendo la más frecuente la tóxico-metabólica (alcohol y tabaco). Las manifestaciones clínicas más frecuentes son el dolor abdominal y los síntomas derivados de la insuficiencia pancreática exocrina. El diagnóstico de la pancreatitis crónica se basa en la detección de: a) alteraciones morfológicas, siendo las pruebas más importantes la ecoendoscopia y la colangiopancreatografía por resonancia magnética con secretina y la resonancia magnética con gadolinio y/o b) alteraciones funcionales, destacando la prueba de secretina. La insuficiencia pancreática exocrina se analiza mediante la prueba de elastasa fecal, asociada a un estudio nutricional completo o con métodos como la prueba del aliento con 13C-triglicéridos mixtos. El tratamiento de la enfermedad se centra en el tratamiento de la causa, en el control de los síntomas, principalmente el dolor, y en el manejo de sus complicaciones funcionales, como la insuficiencia pancreática exocrina y endocrina, o morfológicas, como el pseudoquiste, pseudoaneurisma o el cáncer de páncreas. Chronic pancreatitis is a chronic inflammatory disease of the pancreas that is accompanied by parenchymal fibrosis and loss of functional tissue, which in advanced phases leads to the onset of exocrine and endocrine pancreatic insufficiency. There are various causes that are currently summarised in the TIGAR-O classification, the most common of which is toxic-metabolic (alcohol and tobacco). The most common clinical manifestations are abdominal pain and symptoms resulting from exocrine pancreatic insufficiency. The diagnosis of chronic pancreatitis is based on detecting a) morphological abnormalities (with endoscopic ultrasonography and cholangiopancreatography by magnetic resonance imaging with secretin and magnetic resonance imaging with gadolinium) and/or b) functional abnormalities (with the secretin test). Exocrine pancreatic insufficiency is analysed through the faecal elastase test, combined with a complete nutritional study or with methods such as the 13C-mixed triglyceride breath test. Treatment for the disease is focused on treating the cause, controlling the symptoms (mainly pain) and managing its functional (e.g., exocrine and endocrine pancreatic insufficiency) and morphological complications (e.g., pseudocyst, pseudoaneurysm and pancreatic cancer).

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Fonte de datos: Dialnet