GASTROENTEROLOGY ARTICLE OF THE WEEK
April 9, 2009
Lieb JG, Forsmark CE. A 50 year old woman with unexplained recurrent pancreatitis. Clin Gastroenterol Hepatol 2009;7:141-144
1. Mutations that may be associated with chronic pancreatitis include
a. MSH 1 and MSH 2
b. CFTR
c. HFE
d. PRSS-1 trysinogen gene mutation
e. SPINK-1
f. Pancreatic polypeptide gene mutation
True or False
2. The presence of sludge in the GB in a patient with pancreatitis could indicate microlithiasis as the cause of the pancreatitis
3. A minimally elevated triglyceride level in the hospital excludes hyperlipidemic pancreatitis
4. SPINK-1 mutation, when present, is sufficient to explain the cause for pancreatitis
5. Post-prandial triglyceride levels should be part of the evaluation of a patient with recurrent pancreatitis.
6. A CT of the abdomen with “pancreatic protocol” is probably better than MRI for evaluation of the pancreas after recurrent pancreatitis episodes
7. A patient who is 55 years of age and presents with the first attack of pancreatitis of unknown etiology should be observed. Additional evaluation is warranted only if pancreatitis recurs
8. Empiric cholecystectomy in a patient with recurrent pancreatitis and normal RUQ ultrasound is an acceptable approach