Chronic Pancreatitis

Chronic Pancreatitis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Chronic pancreatitis represents inflammation, fibrosis, and atrophy of acinar cells resulting from recurrent acute or chronic inflammation of the pancreas.
  • Most commonly seen with chronic alcohol abuse, it can also result from dyslipidemia, hypercalcemia, autoimmune disease, and exposure to various toxins. A rare inherited form (hereditary pancreatitis) can be associated with mutations in genes encoding cationic trypsinogen (PRSS1) or pancreatic secretory trypsin inhibitor (SPINK1).1
  • Autoimmune pancreatitis (AIP) is an increasingly recognized subtype of chronic pancreatitis characterized by infiltration of IgG4-positive plasma cells in a classically sausage-shaped pancreas. AIP can be difficult to distinguish from pancreatic cancer on CT, but typically features diffuse narrowing of the main pancreatic duct without dilation.

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General Principles

  • Chronic pancreatitis represents inflammation, fibrosis, and atrophy of acinar cells resulting from recurrent acute or chronic inflammation of the pancreas.
  • Most commonly seen with chronic alcohol abuse, it can also result from dyslipidemia, hypercalcemia, autoimmune disease, and exposure to various toxins. A rare inherited form (hereditary pancreatitis) can be associated with mutations in genes encoding cationic trypsinogen (PRSS1) or pancreatic secretory trypsin inhibitor (SPINK1).1
  • Autoimmune pancreatitis (AIP) is an increasingly recognized subtype of chronic pancreatitis characterized by infiltration of IgG4-positive plasma cells in a classically sausage-shaped pancreas. AIP can be difficult to distinguish from pancreatic cancer on CT, but typically features diffuse narrowing of the main pancreatic duct without dilation.

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