Pancreatic insufficiency

Causes of pancreatic insufficiency in a child include:

• cystic fibrosis
• Shwachmann-Diamond syndrome

Causes in an adult include:

• pancreatic exocrine dysfunction
  • chronic pancreatitis
  • pancreatectomy
• total gastrectomy
  
  
• pancreatic insufficiency in a child leads to malabsorption and failure to thrive:
  • symptoms include:
    • loose, odorous, and frequent stools
    • abdominal pain
      
      
• in an adult:
  • chronic pancreatitis leads to destruction of both exocrine and endocrine tissue - in severe cases the classic triad of diabetes, malabsorption and calcification may be seen; the presenting symptoms are often weight loss and abdominal pain
  • in severe pancreatic insufficiency the patient may complain of bulky, foul smelling stools that stick to the toilet pan; passing grease or oil per rectum is a rare pathognomic sign of pancreatic insufficiency
    
    
• management
  • depends on cause
  • pancreatin

Reference

1. Ghodei A et al. Pancreatic Insufficiency. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.2023