Chronic Pancreatitis
Epidemiology and Etiology:
- Etiologies:
- See acute pancreatitis
- Alcohol is by
far the most common cause
- Long-standing
obstruction
- Pseudocysts
- Calculi
- Trauma
- Neoplasms
- Pancreas divisum
- Cystic fibrosis
Common sites:
Gross features:
- hard pancreas
- dilated ducts
sometimes
- calcified
concretions sometimes
Histologic features:
- parenchymal fibrosis
- reduced number and
size of acini
- relative sparing
of the islets of Langerhans
- may fuse and
appear large
- eventually
disappear as well
- variable dilation
of the pancreatic ducts
- protein plugs in
duct lumens
- ductal epithelial changes
- atrophy
- hyperplastic
- squamous metaplasia
- chronic
inflammatory infiltrate around lobules and ducts
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
- radiology
- calcifications
within pancreas on CT and US
- poor prognosis
long-term
- complications:
- pseudocyst
- duct
obstruction
- malabsorption, steatorrhea
- secondary
diabetes
References: