Reasonable Hypothesis SOP [1] | 64 of 2020 |
Balance of Probabilities SOP [2] | 65 of 2020 |
SOP Bulletin 216 [3]
Chronic pancreatitis is a condition in which there is ongoing inflammation and scarring of the pancreas, with progressive loss of pancreatic function.
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.
* another SOP applies
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).
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.
Place holder node for Rulebase for chronic pancreatitis
Chronic pancreatitis - Acute pancreatitis Factor
Last reviewed for CCPS 21 June 2002.
Clinical onset and operational service [31998]
32000 [5] there is some evidence that acute pancreatitis may be a factor in the development of the condition under consideration.
10617 [5] the veteran has suffered from acute pancreatitis at some time.
10625 [6] the veteran suffered from acute pancreatitis before the clinical onset of chronic pancreatitis. [7]
32008 — the veteran has established the causal connection between the acute pancreatitis and operational service for the clinical onset of chronic pancreatitis.
10627 — the acute pancreatitis is causally related to operational service. [8]
Chronic pancreatitis - Alcohol consumption Factor
Last reviewed for CCPS 21 June 2002.
Investigative Documents
Claimant Report - Alcohol Consumption [CRD904] [9] Claimant Report - Alcohol Consumption [CRV904] [10] Medical Report - Alcohol Consumption [MR9244] Preliminary questions [10452] 10462 — the veteran has established the causal connection between the alcohol consumption and VEA service for the clinical onset of chronic pancreatitis. 10463 — the veteran has established the causal connection between the alcohol consumption and operational service for the clinical onset of chronic pancreatitis. or 10464 — the veteran has established the causal connection between the alcohol consumption and eligible service for the clinical onset of chronic pancreatitis. Clinical onset and operational service [10463] Clinical onset and eligible service [10464]
Chronic pancreatitis - Disorder causing obstruction of the pancreatic ductal system Factor
Last reviewed for CCPS 21 June 2002.
Preliminary questions [24009]
24021 [21] there is some evidence that complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas due to a disease may be a factor in the development of the condition under consideration.
24010 [21] the veteran has suffered complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas due to a disease at some time.
24011 [22] the complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas is due to an illness or injury which is identifiable. the veteran suffered from complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas as a result of the identified illness or injury, at the time of the clinical onset of the chronic pancreatitis. [24]
24013 — the veteran has established the causal connection between the complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas and VEA service for the clinical onset of chronic pancreatitis.
24014 — the veteran has established the causal connection between the complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas and operational service for the clinical onset of chronic pancreatitis.
or
24015 — the veteran has established the causal connection between the complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas and eligible service for the clinical onset of chronic pancreatitis.
Clinical onset and operational service [24014]
24016 — the identified illness or injury, which caused a complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas, is causally related to operational service. [25] [26]
Clinical onset and eligible service [24015]
24017 — the identified illness or injury, which caused a complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas, is causally related to eligible service. [27] [26]
Chronic pancreatitis - Hyperparathyroidism Factor
Last reviewed for CCPS 21 June 2002.
Preliminary questions [31997]
31999 [28] there is some evidence that hyperparathyroidism may be a factor in the development of the condition under consideration.
27174 [28] the veteran has suffered from hyperparathyroidism at some time.
10626 [29] the veteran suffered from hyperparathyroidism at the time of the clinical onset of chronic pancreatitis. [30]
32004 — the veteran has established the causal connection between the hyperparathyroidism and VEA service for the clinical onset of chronic pancreatitis.
32005 — the veteran has established the causal connection between the hyperparathyroidism and operational service for the clinical onset of chronic pancreatitis.
or
32006 — the veteran has established the causal connection between the hyperparathyroidism and eligible service for the clinical onset of chronic pancreatitis.
Clinical onset and operational service [32005]
32010 — the hyperparathyroidism is causally related to operational service. [31] [32]
Clinical onset and eligible service [32006]
32011 — the hyperparathyroidism is causally related to eligible service. [33] [32]
Chronic pancreatitis - Inability to obtain appropriate clinical management for chronic pancreatitis Factor
Last reviewed for CCPS 21 June 2002.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [10456] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [35] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [38] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [43] [44] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [43] [44]
Chronic pancreatitis - Therapeutic radiation to the region of the pancreas Factor
Last reviewed for CCPS 21 June 2002.
Preliminary questions [10455]
10492 [51] there is some evidence that therapeutic radiation to the region of the pancreas may be a factor in the development of the condition under consideration.
10493 [52] the veteran has undergone a course of therapeutic radiation to the region of the pancreas at some time.
23838 [53] the veteran underwent a course of therapeutic radiation to the region of the pancreas for treatment of an illness or injury which is identifiable. 10496 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the pancreas and VEA service for the clinical onset of chronic pancreatitis. 10498 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the pancreas and eligible service for the clinical onset of chronic pancreatitis. or 10497 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the pancreas and operational service for the clinical onset of chronic pancreatitis. Clinical onset and operational service [10497] 10499 — the identified illness or injury for which the course of therapeutic radiation to the region of the pancreas was given is causally related to operational service. [55] [56] Clinical onset and eligible service [10498]
10500 — the identified illness or injury for which the course of therapeutic radiation to the region of the pancreas was given is causally related to eligible service. [59] [56]
Chronic pancreatitis - Trauma to the pancreas Factor
Last reviewed for CCPS 21 June 2002.
Investigative Documents
Medical Report - Trauma - Chronic Pancreatitis [MR9055] Preliminary questions [10454]
10477 [61] the veteran has suffered a trauma to the pancreas at some time. the veteran has suffered a trauma to the pancreas which resulted in complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas. the trauma to the pancreas resulted in complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas at the time of the clinical onset of the chronic pancreatitis. 10480 — the veteran has established the causal connection between the trauma to the pancreas and VEA service for the clinical onset of chronic pancreatitis. 10481 — the veteran has established the causal connection between the trauma to the pancreas and operational service for the clinical onset of chronic pancreatitis. or 10482 — the veteran has established the causal connection between the trauma to the pancreas and eligible service for the clinical onset of chronic pancreatitis. Clinical onset and operational service [10481] or 10486 — the identified illness or injury which caused the trauma to the pancreas resulting in complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas is causally related to operational service. [66] [67] Clinical onset and eligible service [10482] or
10490 — the identified illness or injury which caused the trauma to the pancreas resulting in complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas is causally related to eligible service. [71] [67]
Links
[1] http://www.rma.gov.au/assets/SOP/2020/f84aa6ee1d/064.pdf
[2] http://www.rma.gov.au/assets/SOP/2020/3301915377/065.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20216.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63400%23comment-form
[5] https://clik.dva.gov.au/ccpsc002rc-2
[6] clikpopup://CCPS/Acute pancreatitis before onset of chronic pancreatitis
[7] clikpopup://CCPS/reject10625No
[8] clikpopup://CCPS/reject10627No
[9] https://clik.dva.gov.au/ccpsclaimant-21
[10] https://clik.dva.gov.au/ccpsmedical-19
[11] https://clik.dva.gov.au/10447-veteran-having-been-prisoner-war-japan
[12] clikpopup://CCPS/reject25686No
[13] clikpopup://CCPS/reject10465No
[14] clikpopup://CCPS/reject10466No
[15] clikpopup://CCPS/reject32045No
[16] clikpopup://CCPS/reject32043No
[17] clikpopup://CCPS/reject25937No
[18] clikpopup://CCPS/reject25938No
[19] clikpopup://CCPS/reject32046No
[20] clikpopup://CCPS/reject32044No
[21] clikpopup://CCPS/Disorder causing obstruction of the pancreatic ductal system
[22] clikpopup://CCPS/Obstruction of pancreatic ductal system due to illness or injury
[23] clikpopup://CCPS/reject24011No
[24] clikpopup://CCPS/reject24012No
[25] clikpopup://CCPS/reject24016No
[26] clikpopup://CCPS/reject24016,24017No
[27] clikpopup://CCPS/reject24017No
[28] https://clik.dva.gov.au/ccpsn032rc-38
[29] clikpopup://CCPS/Hyperparathyroidism at time of onset of chronic pancreatitis
[30] clikpopup://CCPS/reject10626No
[31] clikpopup://CCPS/reject32010No
[32] clikpopup://CCPS/reject32010,32011No
[33] clikpopup://CCPS/reject32011No
[34] https://clik.dva.gov.au/ccpsother-31
[35] https://clik.dva.gov.au/node/72421
[36] clikpopup://CCPS/Reject/OnsetAfterService
[37] clikpopup://CCPS/Reject/NoPermanentWorsening
[38] clikpopup://CCPS/Chronic pancreatitis/ACM - contributed to worsening
[39] clikpopup://CCPS/ACM/NoContribution
[40] clikpopup://CCPS/ACM/NotOpService
[41] clikpopup://CCPS/ACM/NotOperDuties
[42] clikpopup://CCPS/rejectwilful
[43] clikpopup://CCPS/ACM/NoIllness
[44] clikpopup://CCPS/reject7390,7391No
[45] clikpopup://CCPS/Chronic pancreatitis/ACM %C2%96 onset prior to operational service
[46] clikpopup://CCPS/ACM/OnsetFailOper
[47] clikpopup://CCPS/ACM/NotEligService
[48] clikpopup://CCPS/ACM/NotEligDuties
[49] clikpopup://CCPS/Chronic pancreatitis/ACM %C2%96 onset prior to eligible service
[50] clikpopup://CCPS/ACM/OnsetFailElig
[51] https://clik.dva.gov.au/ccpsb029rc-15
[52] clikpopup://CCPS/Therapeutic radiation to pancreas at some time
[53] clikpopup://CCPS/Therapeutic radiation to pancreas for illness or injury
[54] clikpopup://CCPS/reject23838No
[55] clikpopup://CCPS/reject10494No
[56] clikpopup://CCPS/reject10499,10500No
[57] clikpopup://CCPS/Therapeutic radiation to pancreas for illness or injury 10 years before onset of chronic pancreatitis
[58] clikpopup://CCPS/reject10495No
[59] clikpopup://CCPS/reject10500No
[60] https://clik.dva.gov.au/ccpsmedical-203
[61] clikpopup://CCPS/Trauma to the pancreas
[62] clikpopup://CCPS/reject10477No
[63] clikpopup://CCPS/reject10478No
[64] clikpopup://CCPS/reject10479No
[65] clikpopup://CCPS/reject10483No
[66] clikpopup://CCPS/reject10485No
[67] clikpopup://CCPS/reject10486,10490No
[68] clikpopup://CCPS/Trauma to pancreas causing obstruction of pancreatic ductal system at time of onset of chronic pancreatitis on el service
[69] clikpopup://CCPS/reject10487No
[70] clikpopup://CCPS/reject10488No
[71] clikpopup://CCPS/reject10490No