Пациент с хроническим калькулезным панкреатитом: задача со многими неизвестными

Abstract

Aim. To describe a clinical case of a patient with diabetes mellitus in the outcome of chronic calcific pancreatitis. Key points. Chronic pancreatitis is a multifaceted disease complicating a great number of body systems work. Currently, the problem of post-pancreatitis diabetes mellitus is receiving more and more attention precisely because simultaneous decrease of the endo- and exocrine functions of the pancreas without timely correction is accompanied by concomitant metabolic disorders that lead to different complaints, hiding the underlying cause. In addition to the familiar to endocrinologists’ problem of correcting hyperglycemia, there is also the problem of exocrine pancreatic insufficiency and vitamin-mineral-protein deficiency. Our patient’s dysfunction of the pancreas was reflected in the appearance of secondary hyperparathyroidism with the formation of osteoporosis, decreased growth, and a pathological fracture. The presented clinical case demonstrates the variety and scale of complications that develop in a patient with chronic calculous pancreatitis. Conclusion. Careful history taking and a comprehensive examination of a patient with a long story of chronic alcoholic pancreatitis should contribute to the timely diagnosis and correction of diseases that develop due to a progressive loss of endo- and exocrine pancreatic function. Keywords: chronic calcific pancreatitis, pancreatic elastase, exocrine pancreatic insufficiency, secondary hyperparathyroidism, osteoporosis, diabetes mellitus.