Chronic pancreatitis. Diagnosis and treatment

Abstract

Chronic pancreatitis is characterized by periodic episodes of inflammation and loss of exocrine and endocrine function of the pancreas. Hereditary pancreatitis is an autosomal dominant disorder with an 80% penetrance, is associated with recurrent episodes of pancreatitis starting in early childhood and correlated to an increased risk of pancreatic cancer. The pathogenesis of chronic and hereditary pancreatitis is not yet fully understood. Patients suffering from chronic pancreatitis present with belt-like abdominal pain, weight loss, and often diabetes mellitus. The diagnosis is made by a combination of imaging procedures such as ultrasound and endoscopic retrograde cholangiopancreatography and exocrine and endocrine function tests. Therapy is restricted to symptom control. Approximately 30-60% of all patients develop disease-associated complications such as persistent pain, strictures of the common bile duct, or pancreatic duct stones which require either interventional or surgical treatment.