Evaluation of the Diagnosis Pancreatitis

Abstract

A widely used classification of pancreatitis is the one proposed in Marseilles in 1963, which distinguishes among acute, acute relapsing, chronic relapsing, and chronic pancreatitis. The diagnostic criteria in chronic pancreatitis are permanent damage of morphology and/or function of the pancreas after clinical symptoms of pancreatitis. In clinical practice, however, it can be difficult to find the suitable and comparable diagnosis in accordance with the Marseilles classification. In the present study the exocrine and endocrine function and the morphology of the pancreas have been thoroughly investigated in 54 patients who have been treated for various diagnoses of pancreatitis. The results show that the above diagnostic criteria often are difficult to interpret. We consider that the prevailing classification of pancreatitis needs to be revised in the light of progress in investigative techniques. A proposal for a modified classification is presented.

Long-Term Outcome of Acute Necrohemorrhagic Pancreatitis

“…Indeed, the S-C test showed a defec tive pancreatic secretion in 40% of the pa tients at the first control, but only in 7% at the second control. This progressive im provement of the exocrine function, noticed also by others [18][19][20], strongly suggests some kind of regeneration of the acinar structures that would be hard to explain in the course of chronic pancreatitis as previously defined, even if a compensatory hypertrophy of the surviving acinar cells has been recently dem onstrated in chronic pancreatitis patients [21], In regard to the ductal lesions visualized at ERP. they could be consistent with chronic pancreatitis.…”

Does Acute Consumption of Large Alcohol Amounts Lead to Pancreatic Injury? A Prospective Study of Serum Pancreatic Enzymes in 300 Drunken Drivers

“…]• However, several recent studies do not support this general assumption. An autopsy study of patients with acute alcoholic pan creatitis found only minimal or no histologic alterations of the pancreas suggesting that there was no underlying chronic disease [11]. Long-term clinical follow-up studies showed complete recovery of the exocrine function in 43 [12], 80 [13] and 100% [14] after severe acute pancreatitis which in many cases was due to alcohol [12][13][14], The same studies also failed to show a progression of the morphological alterations after an acute episode of pancreatitis, including alcoholic pancreatitis [12,14], Finally, Ammann et al [15] recently presented a large prospectively followed series of patients with acute recur rent alcoholic pancreatitis.…”

Comparison of Endoscopic Retrograde Pancreatography with Functional and Histologic Changes in Chronic Pancreatitis

“…Secondly, functional impairment may be obscured by the large reserve capacity of the exocrine pancreas (2). Thirdly, it seems probable that the secretin-CCK test and ERP assess different aspects of the exocrine pancreas and are therefore complementary in the diagnosis of chronic pancreatitis (12,18).…”