The main cause of the chronic pancreatitis were the chronic alcoholism (64%). The other etiology were hyperlipiderma (8%), malnutriation especially 16% patients had clinical biological and histogical evidences related protein malnutriation. The clinical condition were various: the abdominal pain were most common (92%). The position of pain, regardless the acute pain attack can help the diagnosis. The most comon complications were the disorder of glucose toleration (48%) and false cyst in the pancreas (32%), disorder of exocrine functions (24%) in long term studied group.
Pancreatitis, Chronic ; etiology ; diagnosis

In patients with chronic pancreatitis, the pancreaticopleural fistula is known to cause recurrent exudative or hemorrhagic pleural effusions. These are often large in volume and require treatment, unlike the effusions in acute pancreatitis. Diagnosis can be made either by the finding of elevated pleural fluid amylase level or, using imaging studies, by the direct demonstration of the fistulous tract. We report two cases of pancreaticopleural fistula demonstrated by computed tomography.
Amylases ; Diagnosis ; Fistula* ; Humans ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion

In patients with chronic pancreatitis, the pancreaticopleural fistula is known to cause recurrent exudative or hemorrhagic pleural effusions. These are often large in volume and require treatment, unlike the effusions in acute pancreatitis. Diagnosis can be made either by the finding of elevated pleural fluid amylase level or, using imaging studies, by the direct demonstration of the fistulous tract. We report two cases of pancreaticopleural fistula demonstrated by computed tomography.
Amylases ; Diagnosis ; Fistula* ; Humans ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion

Chronic pancreatitis is a progressive disease without curative treatment. Abdominal pain is the most predominant symptom of chronic pancreatitis that initially brings most of the patients to the physician's attention. Some studies have correlated the course of pain in chronic pancreatitis in comparison with the duration of the disease, progressing exocrine and endocrine pancreatic insufficiency, and morphological changes such as pancreatic calcification and duct abnormalities. Furthermore, the course of pain has been studied after alcohol abstinence or surgery in some groups. However, there are only few well-performed and valid studies, and some of them even have produced diversing results, in part. Further controlled studies harvoring a large number of patients in a multicenter setting should be considered. Therapeutic efforts on chronic pancreatitis have focused on palliative treatment of pain which is present in about 80% of cases. Endoscopic treatment of pain in chronic pancreatitis is useful and feasible in many patients. Selecting candidate for endotherapy is mandatory. Main indication of pancreatic stent insertion in chronic pancreatitis is the presence of an obvious ductal stricture. Complications of chronic pancreatitis are also indications of endoscopic intervention. Exocrine and endocrine insufficiencies should be meticulously managed to prevent complications and to maintain good quality of life.
English Abstract ; Humans ; Pancreatitis, Chronic/*diagnosis/*therapy

The present study was intended to examine the spectrum of radiographic patterns of the stomach associated withacute and chronic pancreatitis and their complications. Subjects served for the study consisted of 70 cases ofpancreatitis (36 cases in acute stage and 34 cases in chronic stage). Intramural and perigastic permeation ofextravasated pancreatic enzymes and secondary inflammatory reacation that follows are responsible for theardiographic change observed. 1. Generalized rugal thickening and particularly selective mucosal prominences ingreater curvature of body and antrum are characteristically seen in acute(14 of 36 cases
Diagnosis ; Diagnostic Errors ; Pancreatitis, Chronic ; Stomach

Pseudoaneurysm is uncommon but a life threatening complication of chronic pancreatitis. Angiography has been the standard definitive imaging modality in the diagnosis of pseudoaneurysm. However, over the past 5 years duplux US and Dynamic CT have been proven to be valuable. The authors report a case of gastroduodenal pseudoaneurysm in chronic pancreatitis, which could be diagnosed by duplux US and Dynamic CT. Furthermore this case proved to be a pseudocyst which converted into a pseudoaneurysm by vessel rupture.
Aneurysm, False* ; Angiography ; Arteries* ; Diagnosis* ; Pancreatitis, Chronic* ; Rupture

Splenic artery pseudoaneurysm is a relatively rare and potentially life-threatening complication of chronic pancreatitis. The authors present a case of splenic artery pseudoaneurysm complicating ,chronic pancreatitis. It was converting into a pseudoaneurysm by vessel rupturs. In this case report, color doppler US, CT, and MRI made the definite diagnosis.
Aneurysm, False* ; Diagnosis ; Magnetic Resonance Imaging ; Pancreatitis, Chronic* ; Splenic Artery*

PURPOSE: To classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and toevaluate its significance in differential diagnosis. MATERIALS AND METHODS: In 73 patients with pancreaticdisease (42, acute pancreatitis; 14, chronic pancreatitis; 17, panreatic cancer) abdominal CT findings wereretrospectively reviewed. We defined " infiltration" as linear or irregular density and "thickening" as presenceof a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors forthe differential diagnosis of pancreatic diseases. RESULTS: In 13/42 cases of acute pancreatitis (31%), 4/14 ofchronic pancreatitis (28.6%), and 6/17 of pancreatic cancer (35.3%), periceliac infiltration was observed; thefrequencies were not statistically significant (p=0.916). Peri-SMA infiltration was demonstrated in 9/42 of acutepancreatitis (21.4%), 4/14 of chronic pancreatitis (28.6%), and 5/17 of pancreatic cancer (29.4%); again, thesefrequencies were not statistically significant (p=0.758). Thickening of the celiac trunk and SMA was observed onlyin pancreatic cancer, in 3/17 (17.6%) and 7/17(41.2%) cases, respectively, with statistical significance (p<0.05). CONCLUSION: Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis ofpancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreaticdisease, perivaseular change should be classified as either infiltration or thickening.
Diagnosis, Differential* ; Humans ; Mesenteric Arteries* ; Pancreatic Diseases* ; Pancreatic Neoplasms ; Pancreatitis ; Pancreatitis, Chronic ; Tomography, X-Ray Computed

BACKGROUND/AIMS: A positive correlation between chronic pancreatitis (CP) and pancreatic cancer (PC) has been reported. The aim of this study was to compare the clinical features of PC occurring in CP versus PC without CP with the aim of contributing to the earlier detection of PC in CP patients. METHODS: The study was based on a retrospective chart review performed from 1989 to 2009, of 38 PC patients with underlying CP versus controls. RESULTS: Compared with PC without CP, PC with CP patients were younger at the time of the diagnosis of PC (57.42 vs. 63.94 years; p = 0.01), a greater percentage were smokers (71.1% vs. 50.0%, p = 0.047), and there was pancreatic duct dilatation without a mass on CT findings (15.8% vs. 2.0%, p = 0.018). There was no difference in clinical presentation at the time of PC diagnosis and the CA 19-9 level was elevated in most patients in both groups. Additionally, there was no difference between the groups in terms of resectability (39.5% vs. 26.0%; p = 0.179) or preoperative stage; however, a greater proportion of the PC with CP group underwent surgery (34.2% vs. 16.0%; p = 0.047). CONCLUSIONS: When there is a high suspicion of PC, even if no definite mass is seen on CT in CP patents, we should endeavor to make a diagnosis of PC. Active follow-up of CP patients can allow earlier detection of pancreatic cancer.
Dilatation ; Early Diagnosis ; Follow-Up Studies ; Humans ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis ; Pancreatitis, Chronic ; Retrospective Studies

BACKGROUND/AIMS: This study aimed to evaluate the diagnostic role of low serum amylase and lipase values in the detection of chronic pancreatitis. METHODS: Patients underwent endoscopic retrograde cholangiopancreatography and were diagnosed with non-calcific chronic pancreatitis (NCCP; n=99) and calcific chronic pancreatitis (CCP; n=112). Patient serum amylase and lipase values were compared with those of healthy controls (H; n=170). RESULTS: The median serum amylase (normal range, 19 to 86 U/L) and lipase values (7 to 59 U/L) (P₂₅–P₇₅) were 47.0 (39.8 to 55.3) and 25.0 (18.0 to 35.0) for H, 34.0 (24.5 to 49.0) and 19.0 (9.0 to 30.0) for NCCP, and 30.0 (20.0 to 40.8) and 10.0 (3.0 to 19.0) for CCP, respectively. The cutoff values with the highest diagnostic accuracy for discriminating NCCP from H were 40 U/L for amylase and 20 U/L for lipase, respectively, and for CCP from H were 38 U/L for amylase and 15 U/L for lipase, respectively. For the diagnosis of NCCP with a criterion of serum amylase < 40 and lipase < 20 U/L, the sensitivity, specificity, positive predictive value, and negative predictive values were 37.4%, 88.8%, 66.1%, and 70.9%, respectively. CONCLUSIONS: Serum amylase and/or lipase levels below the normal serum range are highly specific for chronic pancreatitis patients. Clinicians should not ignore low serum pancreatic enzyme values.
Amylases* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Humans ; Lipase* ; Pancreatitis ; Pancreatitis, Chronic* ; Sensitivity and Specificity