<prompt> Answer this question truthfullyWhat are the possible diagnoses that differentiate chronic pancreatitis from other conditions?  <response>: <reason> Abbreviations: RUQ Right upper quadrant of the abdomen, LUQ Left upper quadrant, LLQ Left lower quadrant, RLQ Right lower quadrant, LFT Liver function tests, SIRS Systemic inflammatory response syndrome, ERCP Endoscopic retrograde cholangiopancreatography, IV Intravenous, N Normal, AMA Anti mitochondrial antibodies, LDH Lactate dehydrogenase, GI Gastrointestinal, CXR Chest X ray, US Ultrasound, IgA Immunoglobulin A, IgG Immunoglobulin G, IgM Immunoglobulin M, CT Computed tomography, PMN Polymorphonuclear cells, ESR Erythrocyte sedimentation rate, CRP C-reactive protein, TS Transferrin saturation, SF Serum Ferritin, SMA Superior mesenteric artery, SMV Superior mesenteric vein, ECG ElectrocardiogramDisease Clinical manifestations Diagnosis Comments Symptoms Signs Abdominal Pain Fever Rigors and chills Nausea or vomiting Jaundice Constipation Diarrhea Weight loss GI bleeding Hypo- tension Guarding Rebound Tenderness Bowel sounds Lab Findings Imaging Chronic pancreatitis Epigastric N Increased amylase lipase Increased stool fat content Pancreatic function test CT scan Calcification Pseudocyst Dilation of main pancreatic duct Predisposes to pancreatic cancer Pancreatic carcinoma Epigastric N Alkaline phosphatase serum bilirubin gamma-glutamyl transpeptidase CA 19-9 MDCT with PET CT MRI Skin manifestations may include: Bullous pemphigoid Cicatricial pemphigoid Migratory superficial thrombophlebitis classic Trousseaus syndrome Pancreatic panniculitis Dumping syndrome Lower and then diffuse Hyperactive Glucose challenge test Hydrogen breath test Upper GI series Gastric emptying study Postgastrectomy Inflammatory bowel disease Diffuse Normal or hyperactive Anti-neutrophil cytoplasmic antibody P-ANCA in Ulcerative colitis Anti saccharomyces cerevisiae antibodies ASCA in Crohns disease String sign on abdominal x-ray in Crohns disease Extra intestinal findings: Uveitis Arthritis Irritable bowel syndrome Diffuse N Normal Normal Symptomatic treatment High dietary fiber Osmotic laxatives Antispasmodic drugs Whipples disease Diffuse N Thrombocytopenia Hypoalbuminemia Small intestinal biopsy for Tropheryma whipplei Endoscopy is used to confirm diagnosis. Images used to find complications Chest and joint x-ray CT MRI Echocardiography Extra intestinal findings: Uveitis Endocarditis Encephalitis Dementia Hepatosplenomegaly Arthritis Ascites Disease Abdominal Pain Fever Rigors and chills Nausea or vomiting Jaundice Constipation Diarrhea Weight loss GI bleeding Hypo- tension Guarding Rebound Tenderness Bowel sounds Lab Findings Imaging Comments Tropical sprue Diffuse N Fat soluble vitamin deficiency Hypoalbuminemia Fecal stool test Barium studies: Dilation and edema of mucosal folds Steatorrhea - 10-40 gday Normal5 gday Celiac disease Diffuse Hyperactive IgA endomysial antibody IgA tissue transglutaminase antibody Anti-gliadin antibody Small bowel biopsy US: Bulls eye or target pattern Pseudokidney sign Gluten allergy Colon carcinoma Diffuselocalized Normal or hyperactive if obstruction present CBC Carcinoembryonic antigen CEA Colonoscopy Flexible sigmoidoscopy Barium enema CT colonography PILLCAM 2: A colon capsule for CRC screening may be used in patients with an incomplete colonoscopy who lacks obstruction Viral hepatitis RUQ Positive in Hep A and E Positive in fulminant hepatitis Positive in acute N Abnormal LFTs Viral serology US Hep A and E have fecal-oral route of transmission Hep B and C transmits via blood transfusion and sexual contact. Liver abscess RUQ Normal or hypoactive CBC Blood cultures Abnormal liver function tests US CT Mesenteric ischemia Periumbilical Positive if bowel becomes gangrenous Positive if bowel becomes gangrenous Positive if bowel becomes gangrenous Hyperactive to absent Leukocytosis and lactic acidosis Amylase levels D-dimer CT angiography SMA or SMV thrombosis Also known as abdominal angina that worsens with eating Acute ischemic colitis Diffuse Hyperactive then absent Leukocytosis Abdominal x-ray Distension and pneumatosis CT scan Double halo appearance, thumbprinting Thickening of bowel May lead to shockTo review the differential diagnosis of Abdominal pain, click here.Template:WikiDoc Sources 