Chronic pancreatitis is an irreversible disease of exocrine pancreas characterized by progressive destruction of pancreatic parenchyma and remodeling processes leading to the replacement of the exocrine parenchyma by extensive fibrosis. These changes result in malabsorption, diabetes mellitus and severe and chronic abdominal pain.
Moreover, it is possible the development of several complications which will determine the clinical course developing in some cases pancreatic pseudocyst (25-30%), bile duct strictures (40-50%), even pancreatic cancer (1-3%). The mainstay is detecting early pancreatic changes and treating its related complications.
Pancreatitis
Diagnostic Criteria for Chronic Pancreatitis
Chronic Pancreatitis (CP) is a debilitating disease that classically presents with recurrent bouts of acute pancreatitis, chronic abdominal pain as well as evidence of end organ damage. This is a result of extensive fibrosis and inflammation within the gland that eventually leads to both exocrine and endocrine insufficiency.
International Consensus Diagnostic Criteria for Autoimmune Pancreatitis (AIP)
Autoimmune pancreatitis is a distinct form of pancreatitis characterized clinically by frequent presentation with obstructive jaundice with or without a pancreatic mass, histologically by a lymphoplasmacytic infiltrate and fibrosis and therapeutically by a dramatic response to steroids.
Indications and Contraindications for ERCP in Patients with Acute Biliary Pancreatitis
Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
Diagnostic Criteria for Autoimmune Pancreatitis
Diagnostic Criteria for Autoimmune Pancreatitis by the Japan Pancreas Society
Severity Criteria for Acute Pancreatitis
Ranson Criteria to Predict Severity of Acute Pancreatitis
1. When three or more of the following are present on admission, a severe course complicated by pancreatic necrosis can be predicted with a sensitivity of 60-80%: