Diagnosis

Chronic pancreatitis

Chronic inflammation or recurrent acute pancreatitis characterized by irreversible damage to the pancreatic tissue, resulting in exocrine and endocrine dysfunction.

Etiology

Etiology

Pathophysiology [yfe]

Epidemiology

Incidence per 100.000 [s7z][5nt][yvh][z1k][boc][1t2][sbh][vqz]

Epidemiology chart for Incidence

Prevalence per 100.000 [s7z][5nt][yvh][z1k][boc][1t2][sbh][vqz]

Epidemiology chart for Prevalence

Symptoms & findings

Symptoms

Diarrhea, Malnutrition, Polyuria, Steatorrhea

Clinical findings

Elevated Amylase, Elevated Lipase, Hyperglycemia, Pancreatic atrophy, Pancreatic calcifications, Pancreatic duct irregularity, Pancreatic pseudocysts, Pancreatic swelling

Anamneses

None listed.

Localized findings

Pain
Radiates
Regio epigastricaBack
Onset
Gradual (days)
Pattern
ConstantRecurring
Severity
Mild (1-3)Moderate (4-7)Severe (8-10)

Approach

Treatment

  1. Treatment of etiology: [b7e]

    • Alchoholism

    • Obstruction of the pancreatic duct

  2. Medication:

    • Pain

    • Endocrine insufficiency --> Diabetes

    • Exocrine insufficiency --> Nutritional supplementation

  3. Surgery: When an anatomical complication that is correctable by a mechanical intervention [b7e]

    • Pancreatic pseudocyst: endoscopic or percutaneous drainage

    • Abscess

    • Fistula

    • Ascites

    • Fixed obstruction of the intrapancreatic portion of the distal common bile duct

    • Stenosis of the duodenum with gastric outlet obstruction

    • Variceal hemorrhage due to splenic vein thrombosis

Differential diagnoses

Acute pancreatitis, Bile acid malabsorption, Celiac disease, Cholecystitis, Choledocholithiasis, Cholelithiasis, Chronic mesenteric ischemia, Crohn disease, Gastroenteritis, Lactose intolerance, Pancreatic abscess, Pancreatic cancer, Pancreatic fistula, Parasitic infestations, Short bowel syndrome, Ulcerative colitis, Ulcer disease

References

[1] Goosenberg E, Lappin SL. Chronic Pancreatitis. [Updated 2025 Apr 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482325/

[2] Cai QY, Tan K, Zhang XL, Han X, Pan JP, Huang ZY, Tang CW, Li J. Incidence, prevalence, and comorbidities of chronic pancreatitis: A 7-year population-based study. World J Gastroenterol. 2023 Aug 14;29(30):4671-4684.

[3] Olesen SS, Mortensen LH, Zinck E, Becker U, Drewes AM, Nøjgaard C, Novovic S, Yadav D, Tolstrup JS. Time trends in incidence and prevalence of chronic pancreatitis: A 25-year population-based nationwide study. United European Gastroenterol J. 2021 Feb;9(1):82-90.

[4] Ouyang, G., Pan, G., Liu, Q. et al. The global, regional, and national burden of pancreatitis in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. BMC Med 18, 388 (2020).

[5] Machicado JD, Dudekula A, Tang G, et al. Period prev-alence of chronic pancreatitis diagnosis from 2001-2013in the commercially insured population of the UnitedStates. Pancreatology 2019; 19: 813–818.

[6] Sellers ZM, MacIsaac D, Yu H, et al. Nationwide trendsin acute and chronic pancreatitis among privately insuredchildren and non-elderly adults in the United States,2007–2014. Gastroenterology 2018; 155: 469–478.e1.

[7] Hirota M, Shimosegawa T, Masamune A, et al. The sev-enth nationwide epidemiological survey for chronic pan-creatitis in Japan: Clinical significance of smoking habitin Japanese patients. Pancreatology 2014; 14: 490–496.

[8] Dominguez-Munoz JE, Lucendo A, Carballo LF, et al. A Spanish multicenter study to estimate the prevalence and incidence of chronic pancreatitis and its complications. Rev Esp Enferm Dig 2014; 106: 239–245.

[9] Capurso G, Archibugi L, Pasquali P, et al. Prevalence ofchronic pancreatitis: Results of a primary care physician-based population study. Dig Liver Dis 2017; 49: 535–539.

[10] https://emedicine.medscape.com/article/181554

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