Abdo pain chronic pancreatitis
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You are a core surgical trainee in the outpatient clinic. A 52-year-old man is referred by his GP with recurrent upper abdominal pain and weight loss. He has a background of heavy alcohol use.
Site of pain (epigastric, radiating to back)
Onset and duration (acute vs chronic, recurrent episodes)
Character of pain (deep, boring, constant)
Radiation (especially straight through to the back)
Severity and impact on daily activities
Timing and relation to meals (worse after eating)
Relieving/exacerbating factors (leaning forward, alcohol, food)
Associated nausea and vomiting
Weight loss and anorexia
Steatorrhoea (pale, greasy, foul-smelling stools)
Symptoms of diabetes mellitus (polyuria, polydipsia)
History of alcohol intake (quantity, duration)
Previous episodes of acute pancreatitis
Gallstone history or biliary symptoms (jaundice, colic)
Drug history (e.g. steroids, azathioprine)
Family history of pancreatic disease or malignancy
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