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Chronic Pancreatitis J015

Last amended 
10 September 2020
Current RMA Instruments
Reasonable Hypothesis SOP
64 of 2020
Balance of Probabilities SOP
65 of 2020
Changes from previous Instruments

SOP Bulletin 216

 ICD Coding
  • ICD-9-CM Codes:  577.1, 577.8
  • ICD-10-AM Codes: K86.0, K86.1
Brief description

Chronic pancreatitis is a condition in which there is ongoing inflammation and scarring of the pancreas, with progressive loss of pancreatic function.

Confirming the diagnosis

The diagnosis can be difficult. There is a need to exclude malignant neoplasm of the pancreas.  The diagnosis is based on clinical manfestations, imaging and laboratory studies.  The diagnosis can be confirmed by: calcifications within the pancreas on computed tomography (CT) scan; an abnormal pancreatogram revealing beading of the main pancreatic duct or ectatic side branches; or an abnormal secretin pancreatic function test. 

The relevant medical specialist is a gastroenterologist.

Additional diagnoses covered by SOP
  • Acute on chronic pancreatitis
Conditions not covered by SOP
  • Acute pancreatitis*
  • Pancreatic cyst* - acute pancreatitis SOP
  • Pancreatic pseudocyst* - acute pancreatitis SOP
  • Recurrent acute pancreatitis* - acute pancreatitis SOP 

* another SOP applies

Clinical onset

The common presentation is with abdominal pain, which may occur in discrete attacks early in the course of the condition.  Other symptoms don't tend to develop until the disease is well advanced, but include symptoms of fat malabsorption (particulalry steatorrhoea) and symptoms of diabetes mellitus (due to destruction of pancreatic islet cells).

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Pancreatic damage from chronic pancreatitis is irreversible.  Treatment is mostly symptomatic, involving pain management, replacement of enzyme deficiencies and management of complications.  Cessation of alcohol consumption and smoking may slow the progression of the condition.