Pancreatitis pp 221-227 | Cite as

Complications of Chronic Pancreatitis

  • Peter A. Banks
Part of the Topics in Gastroenterology book series (PEPE, volume 2)


In chronic pancreatitis associated with steatorrhea, clinically significant deficiencies of fat-soluble vitamins (vitamins A, D, and K) do not generally occur (Chapter 13). One important reason is that the composition of dietary fat in the small intestine in pancreatic insufficiency is mostly triglycerides, which do not complex with fat-soluble vitamins, calcium, or magnesium, whereas in diseases of the small intestine, dietary fat is hydrolyzed by pancreatic lipase to free fatty acids, which do complex with these vitamins and cause deficiencies of prothrombin, calcium and magnesium, and vitamin A. Deficiency in vitamin E has been noted in chronic pancreatitis, and has been associated with a variety of histologic changes including ceroid pigmentation of smooth muscle without clinical signs or symptoms of vitamin deficiency.1 Subclinical abnormalities in retinal function appear to correlate with zinc deficiency rather than vitamin A deficiency or steatorrhea.2 Some patients with pancreatic insufficiency have decreased absorption of vitamin B-12, at least by the Schilling test.3 B-12 malabsorption does not appear to be related to the presence or absence of steatorrhea or any other variable that has been tested thus far. A single dose of a potent pancreatic extract is nonetheless able to correct vitamin B-12 malabsorption, but only in vitamin B-12 malabsorption associated with pancreatic insufficiency, and not in pernicious anemia. There is no known method other than the administration of pancreatic extracts to correct this problem.3,4


Common Bile Duct Chronic Pancreatitis Pancreatic Carcinoma Pancreatic Insufficiency Alcoholic Pancreatitis 
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Copyright information

© Plenum Publishing Corporation 1979

Authors and Affiliations

  • Peter A. Banks
    • 1
    • 2
    • 3
    • 4
  1. 1.Tufts University School of MedicineUSA
  2. 2.St. Elizabeth’s Hospital of BostonUSA
  3. 3.Harvard Medical SchoolUSA
  4. 4.Beth Israel HospitalBostonUSA

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