Pancreatitis associated with alcoholic liver disease

Abstract

The prevalence with which alcoholic pancreatitis is associated with alcoholic liver disease is unclear. To investigate this association further, we have reviewed the autopsy findings of 1022 patients who died from alcoholic liver disease and compared these findings with those from 352 patients who died from cardiac or pulmonary disease. All patients who died from liver disease had a history of chronic alcoholism with clinical and biochemical evidence of severe liver damage. Death resulted from hepatic coma, gastrointestinal bleeding, or infection. Liver disease patients were classified into two groups: (1) those with cirrhosis (77%) and (2) those without cirrhosis but with acute and/or chronic sclerosing hyaline necrosis (23%). Anatomic and histopathologic changes characteristic of chronic pancreatitis were found in 203 patients in approximately the same frequency (20% and 18%, respectively) in both groups. Acute pancreatitis without chronic lesions was observed in 8% and 10% of both groups, respectively. In the control group of 352 autopsies (122 cardiac and 230 pulmonary patients), the overall prevalence of pancreatitis, at 2.6%, was significantly (P less than 0.001) lower than that observed in the alcoholic liver disease groups. A total of 22 cases (50%) dying from acute or chronic sclerosing hyaline necrosis had severe chronic calcifying pancreatitis compared to 29 patients (18%) (P less than 0.001) dying from cirrhosis. By contrast, dense fibrosis was significantly (P less than 0.001) more commonly observed in patients with cirrhosis. We conclude that pancreatitis occurs frequently in patients dying from alcoholic liver disease but is an uncommon finding in patients dying from other causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholic chronic pancreatitis and liver cirrhosis: Coincidence and differences in lifestyle

“…Similarly, coexistence of both liver and pancreatic involvement was often found in other autopsy studies [11]. There are two potential explanations of these controversial conclusions: First, autopsy studies, in contrast to clinical studies, might include active and perhaps heavier alcoholics, because patients on long-term follow-up by specialists have often given up or at least controlled their alcohol abuse.…”

Pancreatic Diabetes Mellitus and Heavy Drinking are Risk Factors for the Development of Liver Fibrosis in Alcoholic Chronic Pancreatitis

“…Previous studies with the following methods described the presence of liver fibrosis in 10-20% of patients with ACP: ERCP and secretin-cerulein test (12.5%) [3], liver biopsy (13.3%) [4], autopsy (20%) [5] and TE (10-15%) [6].…”

“…Different morphological and functional examinations have revealed the presence of alcoholic liver fibrosis (ALF) in only 10-20% of alcoholic CP (ACP) patients [3][4][5][6]. The rare coincidence of clinical and morphological alterations in ALF and ACP, and an inverse correlation between the indices of the pancreatic and liver functions evaluated by the fecal elastase-1 test and the indocyanine green test have been described [7].…”

Proteins Differentially Expressed in the Pancreas of Hepatic Alcohol Dehydrogenase–Deficient Deer Mice Fed Ethanol For 3 Months

“…Clinically, significant alcoholic pancreatitis occurs quite frequently in association with alcoholic liver disease 27,28 . Therefore, identification of proteins differentially expressed in the pancreatic tissue of chronic ethanol feeding model of hepatic ADH − deer mice could lead to a better understanding of metabolic basis and mechanism(s) of alcoholic pancreatitis.…”