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Chronic pancreatitis: Clinic, course and diagnostics

Gastroenterologe, ISSN: 1861-9681, Vol: 1, Issue: 1, Page: 18-26
2006
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Review Description

The fist clinical manifestation of chronic pancreatitis is due to long-term alcohol abuse in 80% of cases. So called idiopathic pancreatitis can be associated with SPINK or CFTR mutations. An inflammatory process lasting a decade or more is a risk factor for the development of pancreas cancer. Functional examination is becoming less important in diagnostics. Imaging techniques are important for primary diagnosis and for the planning of treatment. MRCP is a minimally invasive technique for demonstrating bile duct and pancreatic duct stenosis and extension. ERCP is usually only used within the framework of interventional therapy, e.g. bridging of stenoses using stents, removal of pancreatic duct concrements after extracorporeal shock wave lithotripsy, and drainage of pseudocysts. Endosonography is currently the most sensitive imaging technique for an early diagnosis, and Doppler signals show vessels which must not be damaged during drainage. CT shows inflamed pancreas tumors, calcifications and pseudocysts. Whether positron emission tomography will solve the problem of timely diagnosis of cancer as consequence of chronic inflammation is more than questionable. Studies are needed to clarify whether endoscopically steered pancreas biopsy can solve the problem of unclear pancreas tumors. © Springer Medizin Verlag 2006.

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