Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with recurrent episodes of epigastric pain radiating to the back, consistent with known hereditary pancreatitis (SPINK1 mutation). Symptoms include postprandial exacerbation, nausea, and occasional vomiting. No current signs of acute cholangitis or biliary obstruction. Patient reports compliance with pancreatic enzyme replacement therapy (PERT) and dietary modifications.
Clinical Examination Findings
General: Patient appears in mild distress due to abdominal discomfort. Abdomen: Soft, non-distended, with localized epigastric tenderness on deep palpation. No rebound tenderness or guarding. Bowel sounds present. No palpable masses or organomegaly. Skin: No jaundice or xanthomas. Vitals: Stable, afebrile.
Treatment Protocol
1. Pancreatic Enzyme Replacement Therapy (PERT): Titrate dose based on fat content of meals. 2. Pain Management: Scheduled non-opioid analgesics; avoid alcohol and tobacco. 3. Nutritional Support: Low-fat, high-protein diet; monitor for fat-soluble vitamin deficiencies (A, D, E, K). 4. Surveillance: Annual screening for pancreatic adenocarcinoma via EUS or MRI/MRCP.