Chronic pancreatitis occurs when acute pancreatitis heals with scarring.
The small ducts within the pancreas are narrowed in certain areas (strictures) and this leads to plugging up of these sections within the pancreas with backing up of the highly corrosive secretions, which were meant to digest food, not the pancreas itself. After a few months and years of recurrent pancreatitis attacks the scarred up areas of the pancreas calcify and this can be seen on X-rays. Here is an image showing the progression from acute to chronic pancreatitis.
Symptoms of Chronic Pancreatitis
The pancreatitis attacks are very similar to the ones described above under acute pancreatitis. However, there are now more symptoms of chronicity. As the function of the digestive system is more and more missing due to the loss of enzyme production in the pancreas, the patient experiences rapid weight loss. When the digestive function is reduced to less than 10% of normal, the patient complaints of undigested fat in the bulky stools (“steatorrhea”). High blood sugar levels from a lack of insulin develop (diabetes mellitus has developed).
Diagnostic Tests of Chronic Pancreatitis
Most of the diagnosis is likely already on record from previous attacks. X-rays and CT scan show the chronically scarred, abnormal pancreas. Blood tests concentrate more on diagnosing the severity of diabetes. The gastroenterologist might want to do a secretion test of the pancreas with the injection of secretin and an ERCP with a cannula in the ampulla of Vater. Often it is there that a gall stone gets stuck.
Chronic Pancreatitis
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