The Early Diagnosis of Chronic Pancreatitis

Reaching a correct diagnosis is straightforward in most patients with long-standing chronic pancreatitis. These patients have easily identifiable abnormalities of the pancreas. These abnormalities may be of the structure or the function of the gland. Abnormalities of pancreatic structure might include pancreatic ductal dilation, pancreatic parenchymal atrophy, or pancreatic calcifications. Abnormalities of pancreatic function could include exocrine or endocrine insufficiency. This type of patient usually has a long history of clinical illness, often with multiple clinic visits or hospitalizations for abdominal pain or complications of chronic pancreatitis. Although the management of this type of patient may be quite challenging, the diagnosis is not. Widely available diagnostic tests such as computed tomography (CT) or magnetic resonance imaging (MRI with magnetic resonance cholangiopancreatography [MRCP]) will document the presence of chronic pancreatitis.¹