Clinical Study of Chronic Pancreatitis

Chun, Moon Gi; Kim, Chang Duck; Hyun, Jin Hae

Abstract

BACKGROUND AND AIMS: Chronic pancreatitis is a chronic inflammatory process leading to destruction of exocrine tissue, fibrosis, and in some patients, loss of endocrine tissue. A multiplicity of causes may lead to chronic pancreatitis; however, chronic alcohol abuse appears to be the etiologic basis in 70 80% of adult patients. As the problem of chronic alcoholism has grown in the our country, the prevalence of chronic pancreatitis is increasing. However, few reliable studies have been performed concerning the clinical features of chronic pancreatitis in Korea. So we investigate the clinical characteristics and diagnostic accuracy of imaging studies in chronic pancreatitis.
METHODS
We analyzed the 91 patients with chronic pancreatitis who were diagnosed and managed at Anam Hospital, Korea University in Seoul frorn January 1988 to December 199i.
RESULTS
The sex incidence showed male predominance with a male to female ratio of 4.7:1 and peak age groups were 5th and 6th decades. Most common cause of chronic pancreatitis was chronic alcohol consumption (54.9%), and the other causes were biliary disease, anomaly of the pancreas, hyperlipidemia, and hyperparathyroidism. Cause was not identified in 20.9% of patients. Most of patients complaints abdominal pain (91%), and other eomplaints were indigestion (,'3.6%), weight loss (39.6%), jaundice (13.2%) or diarrhea (8.8Yo). Elevated serum amylase and fasting sugar level were shown in 39.6% and 29.7% of patients respectively. Sensitivity of abdorninal sonogram, CT scan, and ERCP were 59%, 78% and 89% in diagnosis of chronic pancreatitis respectively. CT scan was supetior to other methods in detection of pancreatic calcification and smail cystic lesions, and ERCP was superior to others in detection of minor ductal change. Twenty-one cases were accom- panied by complications such as pseudocysts, biliary stenosis, duodenal obstruction, splenic vein thrombosis & pseudoaneurysm. Endoscopic treatment was given in 12 cases and surgical operation was performed in 19 cases due to complicaiton.
CONCLUSIONS
Chronic alcohol comsumption is a major cause of chronic pancreatitis. CT and ERCP are essential diagnostic tool in evaluating morphological changes of chronic pancreatitis.