Chronic pancreatitis is very difficult to define unambiguously, therefore it is required to conduct differential diagnosis, excluding intestinal tuberculosis, chronic colitis, pancreatic cancer, solaritis, abdominal ischemic syndrome, cholelithiasis, duodenal ulcer, stomach cancer.
The main diffusion of intestinal tuberculosis from pancreatitis will be the primary focus of the disease in the lungs, tuberculosis of the caecum and the thermal section of the small intestine. Blood on the analysis shows hypochromic anemia, the patient has sweating, weakness, fatigue, diarrhea and subfebrile temperature.
Excluding tuberculosis, differential diagnosis of pancreatitis continues, comparing the symptoms of the disease with ischemic pain syndrome, which usually occurs in the abdomen around 30 minutes after eating. Such pain can not be removed with narcotic or antispasmodics. Not infrequently observed are alternating with bloody diarrhea constipation, signs of atherosclerosis of the abdominal aorta and increased pressure( 40 - 60 mm Hg).
Another disease with similar symptoms is the solarite. A common symptom in pancreatitis and solarar are the irradiative pains in the lower back pain from the left hypochondrium, and they can be distinguished by the absence of an impairment of the incremental and secretory function of the gland. On the roentgenogram there are no pathological changes.
For a complete diagnosis, chronic colitis should be excluded, for which internal and external secretion disorders, spastic blunt pains, constipation and spastic component on the irrigography are characteristic.
Often in patients with suspected pancreatitis in a differential diagnosis, it is found that the cause of pain in the back and abdomen has become a cancerous lesion of the gland's body, and signs of jaundice develop against the background of the localization of cancer in the head of the pancreas. In addition to cancer, there is weight loss, poor appetite, rapid development of metastases, symptoms of Terje-Courvoisier and liver damage.
Ulcerous diseases of the duodenum and stomach are characterized by periods of alternation of exacerbations with phases of remission. With more detailed diff diagnosis, increased acidity and hypersecretion of juices are observed, and on the roentgenogram the formation of a niche and ulcerative defect in fibrogastroscopy.
The last thing you need to sweep away in the differential diagnosis of pancreatitis is a cholelithiasis. The pain with it is localized in the right hypochondrium and is given to the scapula or shoulder. Often the disease is supplemented with hepatic colic and muscle strain during palpation in the right hypochondrium, and positive reactions to the symptom of Murphy, Ortner and Mussie-Georgievsky are also observed.