Pancreatitis crónica

Abstract

Chronic pancreatitis is a chronic inflammatory disease of the pancreas that is accompanied by parenchymal fibrosis and loss of functional tissue, which in advanced phases leads to the onset of exocrine and endocrine pancreatic insufficiency. There are various causes that are currently summarised in the TIGAR-O classification, the most common of which is toxic-metabolic (alcohol and tobacco). The most common clinical manifestations are abdominal pain and symptoms resulting from exocrine pancreatic insufficiency. The diagnosis of chronic pancreatitis is based on detecting a) morphological abnormalities (with endoscopic ultrasonography and cholangiopancreatography by magnetic resonance imaging with secretin and magnetic resonance imaging with gadolinium) and/or b) functional abnormalities (with the secretin test). Exocrine pancreatic insufficiency is analysed through the faecal elastase test, combined with a complete nutritional study or with methods such as the 13C-mixed triglyceride breath test. Treatment for the disease is focused on treating the cause, controlling the symptoms (mainly pain) and managing its functional (e.g., exocrine and endocrine pancreatic insufficiency) and morphological complications (e.g., pseudocyst, pseudoaneurysm and pancreatic cancer).