The symptoms of pancreatic disease are usually protean so the blood tests have an important role in establishing the diagnosis. The diseases affecting the pancreas are: pancreatitis (acute, chronic, autoimmune and hereditary), pancreatic tumors, diabetes mellitus and pancreatic enzyme deficiency.


Acute pancreatitis is an inflammatory disease of the pancreas which may also affect peripancreatic tissue or remote organs. The disease is usually determined by gallstones, alcohol abuse, drugs or it may be idiopathic. Severe abdominal pain located in the epigastric region and sometime radiating to the back is almost always present and in some cases it is refractory to analgesics. The pain is in many cases more intense if the patient is supine. Muscular rigidity, an enlarged, palpable pancreas and abdominal tenderness may also be observed. The patient is frequently anxious or distressed, with a mild fever and hypotension. In severe necrotising pancreatitis hemoperitoneum may lead to a bluish discoloration around the umbillicus and tissue catabolism may be reflected by a blue-red discoloration on the flanks. Almost one in four patients who once had an attack of acute pancreatitis will experience, due to alcohol or cholelitiasis a recurrence.

In autoimmune pancreatitis the symptoms consist in mild abdominal pain, with diffuse swelling of the pancreas. The attacks of pancreatitis are rare. The disease is usually accompanied by obstructive jaundice.

In chronic pancreatitis the pain varies in intensity and it may be intermittent. The pain may be exacerbated after meals leading to anorexia and weight loss. Despite of the steatorrhea (fatty stools) most of the patients do not have the symptoms of vitamin deficiency. The maldigestion, another feature of chronic pancreatitis manifests as steatorrhea, fatigue, weight loss and chronic diarrhea. Mild fever and mild abdominal tenderness may also be observed.

Hereditary pancreatitis has similar symptoms to chronic pancreatitis. The clinical features of this disorder are:pancreatic calcification, steatorrhea, and recurring severe abdominal pain attacks. The patients with this disorder have an increased risk of pancreatic carcinoma.

Diabetes mellitus is a disorder in which the pancreas doesn't produce sufficient insulin. The disease has three forms: type one, type two or gestational. Polyuria (frequent urination) and polydipsia (increased thirst) are considered to be the classical symptoms of the disease. Inspite of the polyfagia (increased hunger) in type 1 diabetes a rapid significant weight loss may be observed. Vision changes (blurred vision) may occur, determined by the changes in the shape of the eye lenses. Kussmaul breathing is one of the first symptoms of the disease and it consists in the scent of acetone in the patient's breath. Abdominal pain, nausea, vomiting and altered mental state may also occur. In severe, diabetic ketoacidosis coma may occur, leading to death.

Pancreas enzyme insufficiency is determined by the inability of the pancreas to produce the necessary amount of digestive enzymes. This disorder is usually determined by the progressive pancreatic damage. The symptoms of this disorder are:weight loss, diarrhea and steatorrhea. Abdominal pain it is absent but in some cases it may be determined by other disorders affecting the pancreas.

The clinical features of pancreatic endocrine tumors are usually determined by the increased amount of hormones and only in the late stages the tumor itself will cause abdominal pain. Sometimes, weight loss, bleeding, fatigue and jaundice may occur.