A nurse is reviewing the clinical presentation and management of acute and chronic pancreatitis with a group of nursing students. Match the clinical feature to the appropriate category based on whether it is associated with acute pancreatitis, chronic pancreatitis, or both. Each item may be used only once.

Elevated serum lipase and amylase. Acute Pancreatitis: The sudden inflammation of the pancreas causes the leakage of digestive enzymes into the systemic circulation. Lipase is more specific for pancreatic tissue and remains elevated longer than amylase during an acute episode. These biomarkers are essential for the initial diagnosis of acute injury but may be normal in advanced chronic stages. Sudden, severe, epigastric pain radiating to the back. Both: Inflammation or ductal obstruction causes intense visceral pain that typically bores through to the posterior trunk. In acute cases, the onset is rapid, while in chronic cases, this pain can occur during acute exacerbations. Both conditions share this classic pain distribution due to the retroperitoneal location of the pancreatic organ. Persistent left upper quadrant abdominal pain. Both: The tail of the pancreas extends into the left hypochondriac region, leading to localized tenderness and pain. Chronic inflammation causes constant dull aching, whereas acute episodes cause sharp, guarding-related discomfort in this area. Nursing assessment focuses on the LUQ and epigastrium as the primary sites of pancreatic distress. Steatorrhea (fatty stools). Chronic Pancreatitis: Long-term destruction of acinar cells leads to exocrine insufficiency and a lack of lipase production. This results in the malabsorption of fats, manifesting as bulky, foul-smelling, oily stools that float in water. This symptom is a hallmark of permanent structural damage and the loss of digestive enzyme secretion.