A 49-year-old man with a 20-year history of alcohol use presents with bulky, foul-smelling stools, progressive weight loss, and easy bruising. Vital signs show BP 128/76, HR 88, RR 16, temperature 37°C, SpO2 98%. Laboratory studies reveal fecal elastase <200 μg/g, prothrombin time 18 seconds, and albumin 2.8 g/dL. Abdominal ultrasound demonstrates normal liver echotexture. Which of the following is the most likely underlying diagnosis?

  1. A)Celiac disease
  2. B)Chronic pancreatitisGABARITO
  3. C)Gilbert syndrome
  4. D)Lactase deficiency
  5. E)Ulcerative colitis

Explicação

Chronic pancreatitis causes irreversible destruction of pancreatic parenchyma, leading to exocrine insufficiency with steatorrhea and fat-soluble vitamin deficiency. A low fecal elastase level supports pancreatic exocrine failure, and chronic alcohol use is a ... Ver explicação completa e trilha adaptativa →

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