A 60-year-old alcoholic man presents with a 6-month history of recurrent epigastric pain, progressive weight loss, and foul-smelling diarrhea. The abdominal pain is now almost constant and intractable. An X-ray film of the abdomen reveals multiple areas of calcification in the mid-abdomen. Which of the following is the most likely diagnosis?
High-Yield Explanation
Chronic pancreatitis is characterized by the progressive destruction of the pancreas, with accompanying irregular fibrosis and chronic inflammation. Calcification and intraductal calculi often develop. Pancreatic insufficiency results in malabsorption syndrome. Chronic pancreatitis is most commonly seen in patients with a history of alcohol abuse (70% of cases). The other choices are not associated with pancreatic calcifications. Although islets may be affected by chronic pancreatitis, hypoglycemia is an uncommon and late feature of the disease.Diagnosis: Pancreatitis, chronic