Diagnosis and management of chronic pancreatitis: current knowledge

Swiss Medical Weekly
R Ammann

Abstract

This paper reviews the current literature on chronic pancreatitis (CP). Despite marked progress in diagnostic tools, predominately imaging methods, no consensus has been reached on the nomenclature of CP, ie diagnosis, classification, staging, pathomechanisms of pain and its optimal treatment. A major problem is that no single reliable diagnostic test exists for early-stage CP except histopathology (rarely available). This stage is characterised typically by recurrent acute pancreatitis +/- necrosis (eg pseudocysts). Acute pancreatitis is a well-defined condition caused in 80% of cases by gallstones or alcohol abuse. Alcoholic pancreatitis, in contrast to biliary pancreatitis, progresses to CP in the majority of patients. However, a definite CP-diagnosis is often delayed because progressive dysfunction and/or calcification, the clinical markers of CP, develop on average 5 years from disease onset. The progression rate is variable and depends on several factors eg aetiology, smoking, continued alcohol abuse. Repeated function testing eg by the faecal elastase test, is the best alternative for histology to monitor progression (or non-progression) of suspected (probable) to definite CP. The pathomechanism of pain in CP is multifac...Continue Reading

Citations

Jan 6, 2007·Orphanet Journal of Rare Diseases·Jonas RosendahlNiels Teich
Nov 14, 2013·World Journal of Gastroenterology : WJG·Yun BianBing-Hui Zhao
Nov 22, 2013·World Journal of Gastroenterology : WJG·Jing-Bo ZhaoThomas Dahl Nissen

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