Serum immunoglobulins in calcific pancreatitis
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Serum immunoglobulin concentrations were measured in 40 patients with calcific pancreatitis. A significant elevation of the mean serum IgA and IgG concentration when compared with a control group was found. The IgA was raised in 50% and the IgG in 27·5% when the individual results were assessed. The IgA did not appear to be of the secretory type. The possible significance of the raised IgA and IgG is discussed with reference to local pancreatic IgA production, autoimmune factors in chronic pancreatitis, and the ductal protein plugs in this disease.Preface Contributors The history of chronic pancreatitis Molecular pathogenesis and gentic alterations in chronic pancreatitis Pathogenesis of chronic pancreatitis: Current state and trends Chronic pancreatitis: The role of nerves and neuroimmune interaction Diagnosis of chronic pancreatitis: Function tests Chronic pancreatitis: Diagnostic imaging Chronic pancreatitis: An attempt to classify Difficult decision-making in chronic pancreatitis: An interactive workshop Chronic pancreatitis diabetes mellitus and nutrition Conservative treatment of chronic pancreatitis 100th anniversary of pancreatic enzyme treatment Endoscopic treatment of chronic pancreatitis: Impact on long-term outcome Surgical treatment of chronic pancreatitis: Standard procedures Surgical treatment of chronic pancreatitis: Long-term results Index
Pathogenesis
Pancreatitis, chronic
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In the initial genetic studies about pancreatitis in Korea, gene mutations were thought to be rare. However, the recent findings of PRSS1, SPINK1, and CFTR mutations in patients with idiopathic chronic pancreatitis or inherited cases of chronic pancreatitis are much more common than originally predicted. Therefore, it is important to identify underlying genetic background in idiopathic chronic pancreatitis to avoid progression and development of complications. In addition, concentrated and strict follow-up must be given to the patients because of very high risk of pancreatic cancer. However, it is also true that studies about genetics in pancreatitis were not enough to compare with Western studies. Accordingly, further large scale studies are necessary to find other unknown possible genes that could be related to the chronic and hereditary pancreatitis. Keywords: Genetics, Pancreatitis, PRSS1, SPINK1, CFTR Keywords: ì ì ì±, ì·ì¥ì¼, PRSS1, SPINK1, CFTR
Hereditary pancreatitis
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Relation between cancer of the exocrine part of the pancreas and chronic pancreatitis has not been clearly defined and the problem of carcinogens based on long-lasting chronic pancreatitis is still a matter of discussion.The aim of the study was analysis of postoperative material of patients who in the years 1999-2003 underwent either drainage procedures (n=49) in the course of chronic pancreatitis or resectional procedures (n=36) for chronic pancreatitis or pancreatic cancer.In the group of patients with drainage procedures pancreatic cancer was histologically detected in postoperative material (specimens collected from the wall of pancreatic pseudocyst or dilated main pancreatic duct) in 3 patients (6.1%). In the group of patients with long-lasting chronic pancreatitis who underwent a resectional procedure pancreatic cancer was postoperatively detected in 4 cases (30.7%).Analysis of presented material confirms that long-lasting chronic pancreatitis predisposes to cancer of the exocrine part of the pancreas. This indicates that risk of pancreatic cancer should be taken into consideration in each patient with long lasting chronic pancreatitis.
Pancreatitis, chronic
Pancreatic Disease
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Pancreatitis, chronic
Pancreatic Disease
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Pancreatitis, chronic
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Abstract This study examines the value of endoscopic pancreatography in chronic pancreatitis. With the cooperation of nine departments in Italy, the authors examined the pancreatograms of 1179 patients with chronic pancreatitis. The pancreatograms were abnormal in 80·6 per cent. There were difficulties in distinguishing between cancer and pancreatitis in 11·3 per cent, and difficulty in deciding whether the radiographs were normal or slightly abnormal in 6·8 per cent. The ability of pancreatography to diagnose chronic pancreatitis increased with the duration of the disease, reaching 92·3 per cent in those patients who had had chronic pancreatitis for 5 or more years. However, the failure to obtain a pancreatogram increased as calcification increased. A good correlation between abnormalities of the pancreatogram and of the pancreatic function tests was demonstrated.
Pancreatic Disease
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This chapter contains sections titled: Introduction Benign disease, chronic inflammation, and cancer: evidence from other organs Chronic pancreatitis and pancreatic cancer: descriptive data Chronic pancreatitis and pancreatic cancer: is there a link? Uncommon types of pancreatitis Risk factors for developing pancreatic cancer after chronic pancreatitis From pancreatitis to pancreatic cancer: defining the pathways Chronic pancreatitis and development of nonpancreatic cancer Screening issues Acknowledgments References
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Because examinations of pancreatic exocrine function have been difficult to perform in Japan, the importance of imaging diagnosis of chronic pancreatitis has been increasing. Therefore, the findings of US, CT, MRI, EUS and ERP have great weight with the new clinical diagnostic criteria of chronic pancreatitis. In the new criteria, chronic pancreatitis can be diagnosed as "definite chronic pancreatitis", only with one or more findings of "specific image of chronic pancreatitis". Consequently, the findings of "specific image of chronic pancreatitis" are determined strictly. The clinical value of the new diagnostic criteria of chronic pancreatitis should be evaluated in many hospitals with many patients with several stages of chronic pancreatitis in the near future.
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e c e n t s u r ve y s o n c h r o n i c pancreatitis carried out around the world shows that alcohol remains the main factor associated with chronic pancreatitis, even if at a frequency lower than that reported previously.It has further confirmed that heavy alcohol consumption and smoking are independent risk factors for chronic pancreatitis.Autoimmune pancreatitis accounts for 2%-4% of all forms of chronic pancreatitis, but this frequency will probably increase over the next few years.The rise in idiopathic chronic pancreatitis, especially in India, represents a black hole in recently published surveys.Despite the progress made so far regarding the possibility of establishing the hereditary forms of chronic pancreatitis and the recognition of autoimmune pancreatitis, it is possible that we are more inaccurate today than in the past in identifying the factors associated with chronic pancreatitis in our patients.
Etiology
Autoimmune Pancreatitis
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The article tells about current issues in the treatment of chronic pancreatitis in adults. Particular attention is paid to the use of enzyme preparations as replacement and symptomatic therapy in chronic pancreatitis. There is a brief description of antispasmodics used for relief of abdominal pain in chronic pancreatitis.
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