Idiopathic chronic pancreatitis in India: phenotypic characterisation and strong genetic susceptibility due to SPINK1 and CFTR gene mutations

Abstract

Strong genetic susceptibility due to SPINK1 and CFTR gene mutations, and comparative phenotype of idiopathic CP in India suggest that the term 'tropical calcific pancreatitis' is a misnomer.

Extracorporeal shock wave lithotripsy (ESWL) for large pancreatic stones: are these shocks worth while?

“…Abdominal pain is the most common and distressing symptom and is the most common indication for endoscopic or surgical intervention [1,4,5]. One of the mechanisms responsible for pain in chronic pancreatitis is obstruction to the pancreatic duct by strictures or calculi and relief of this obstruction by surgical or endoscopic drainage relieves pain in a majority of patients [6][7][8].…”

“…On plain X-ray of the abdomen, pancreatic calcification can be seen in up to 30% of patients with chronic pancreatitis [4]. The advent of newer imaging modalities like computed tomography (CT) has improved the ability to detect pancreatic calcification [9].…”

“…In India, idiopathic chronic pancreatitis is the most common form of chronic pancreatitis [3,4] and a study from southern India has shown that pancreatic duct stones in tropical pancreatitis are often large and dense as compared to other etiologies of chronic pancreatitis [28]. It would be interesting to know the effect of ESWL in these large and dense stones.…”

Micronutrient ('Antioxidant') Therapy for Chronic Pancreatitis: Basis and Clinical Experience

“…The worst combination appears to be in patients with tropical pancreatitis (30,102,103). The populist notion of pancreatic autodigestion by prematurely activated trypsin in acinar cells has no part in the philosophy (17,25,26,118), and is increasingly challenged by its former proponents (124).…”

“…This is not the position depicted in Figure 1, which instead seeks to understand the increased frequency of CFTR mutation(s), with or without mutation in SPINK1, among patients with idiopathic chronic pancreatitis (97), especially the tropical variant (102).…”