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Pankreatit, kronisk

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Sakkunnig:
Definition:
Kronisk inflammation som leder till kvarstående skada av pankreas.
Förekomst:
I Europa är prevalensen är 120/100 000 personer och incidensen är 5–10/100 000 personår.
Symtom:
Kroniska eller recidiverande magsmärtor, ibland måltidsrelaterade, viktnedgång och något mer sällan steatorré och symtom som vid diabetes mellitus.
Kliniska fynd:
Tecken till undernäring vid exokrin svikt. Ömhet vid bukpalpation. Eventuellt fynd som överensstämmer med långvarigt högt alkoholintag.
Diagnostik:
Minskat P/S-amylas eller P/S-lipas kan förekomma. Typiska fynd vid medicinsk bilddiagnostik där DT-undersökning i flera kontrastfaser (pankreasprotokoll) är förstahandsmetod. 
Behandling:
Upphöra med, eller kraftigt minska intag av, alkohol. Rökstopp. Smärtlindring, pankreasenzymer (vid exokrin pankreas svikt), diabetesbehandling (vid endokrin pankreassvikt) och näringstillskott om malnutrition föreligger. I vissa fall är endoskopiska och kirurgiska åtgärder indicerade.
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  • Jon Tsai, med dr och kirurg specialiserad inom övre gastro, Karolinska Institutet
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet