Chronic Pancreatitis: Complications

Lankisch, P. G.; Banks, Peter A.

doi:10.1007/978-3-642-80320-8_18

Cited by 3 publications

(4 citation statements)

References 91 publications

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“…Previous studies have reported that the presence of LC in patients with CP was variable, ranging between 5% and 30% [56] . Later, Angelini et al [19] found 12.5% of LC cases in CP patients.…”

Section: Discussionmentioning

confidence: 98%

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Aparisi¹,

Sabater²,

Del-Olmo³

et al. 2008

WJG

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AIM:To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes. METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed. RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients. CONCLUSION:There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

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Section: Discussionmentioning

confidence: 98%

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Aparisi¹,

Sabater²,

Del-Olmo³

et al. 2008

WJG

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“…114 The manifestation of severe organ complications and surgical interventions represent major events during the course of the disease, as loss of pancreatic function often results from surgical interventions, and severe organ complications may exert an infl uence on the prognosis of the disease. 91 Within the M-ANNHEIM scoring (Table 8), we linked irreversible complications with a higher score, since these complications are more likely to infl uence the long-term prognosis of the disease. Therefore, from the fi rst occurrence onward, these features need to be rescored each time a new severity index is calculated.…”

Section: M-annheim Score and M-annheim Severity Indexmentioning

confidence: 99%

“…[2][3][4][5] M-ANNHEIM defi nition of severe complications Several severe complications frequently occur during the course of chronic pancreatitis and have an impact on the prognosis of the disease. 91 We divided the severe complications listed by Lankisch and Banks 91 into possibly reversible features (such as the presence of stenosis of adjacent viscera, e.g., duodenal stenosis, colonic stenosis, common bile duct stenosis; gastrointestinal bleeding; development of ascites; occurrence of pleural effusion; osseous lesions; pseudoaneurysm, pancreatic fi stula) and irreversible complications (portal or splenic vein thrombosis with or without portal hypertension; occurrence of pancreatic cancer). It is noteworthy that these severe complications are not included among the morphological imaging features of the Cambridge classifi cation system.…”

Section: M-annheim Defi Nition Of Onset Of Chronic Pancreatitismentioning

confidence: 99%

The M-ANNHEIM classification of chronic pancreatitis: introduction of a unifying classification system based on a review of previous classifications of the disease

2007

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The M-ANNHEIM multiple risk factor classification system is simple, objective, accurate, and relatively noninvasive, and it incorporates etiology, different stages of the disease, and various degrees of clinical severity. This new classification system will be helpful for investigating the impact and interaction of various risk factors on the course of the disease and will facilitate the comparison and combination of interinstitutional data.

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“…Alcohol-related CLD was present in eight patients of alcohol-related CP (8.4 %). One study reported that the presence of CLD in patients with CP was variable, ranging between 5 % and 30 % [4]. The clinical manifestations, functional parameters, and imaging characteristics of alcoholrelated CLD in patients with alcohol-related CP were also studied.…”

mentioning

confidence: 99%

Chronic liver disease in alcohol-related chronic pancreatitis patients: Does lightning strike twice?

Soni

Singh

Nijhawan

et al. 2015

Indian J Gastroenterol

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Alcohol abuse is one of the commonest addictions in the world. Alcohol consumption has increased drastically over last two decades in India [1]. Along with increase in alcohol use, there is a rise in alcohol-related pancreatic and liver diseases. In clinical practice, the concurrent manifestion of both diseases, chronic pancreatitis (CP) and chronic liver disease (CLD) in the same patient is rare [2]. Furthermore, these two diseases do not share risk factors apart from alcohol consumption [2]. Very few studies in the world literature have assessed the frequency of occurrence of CLD among alcohol-related CP. This study was done to determine the prevalence of alcohol-related CLD in patients of alcohol-related CP and to look for the differences between patients having CP associated with CLD vs. CP only.We evaluated all the consecutive alcohol-related chronic pancreatitis patients admitted between . As the majority of the patients presenting for the first time as alcoholic acute pancreatitis usually have underlying chronic pancreatitis, they were included in the study [3]. The diagnosis of acute pancreatitis was according to revised Atlanta classification 2012. The diagnosis of chronic pancreatitis was based on clinical, biochemical, radiological, and/or endoscopic retrograde cholangiopancreatography (ERCP) findings. CLD was diagnosed based on clinical, biochemical, radiological, and/or endoscopic findings. Patients with pancreatic and liver malignancies, hepatitis B, hepatitis C, nonalcoholic fatty liver disease, diabetes mellitus, autoimmune hepatitis, and gallstone diseases were excluded from the study. The demographic and historical information of patients addressing alcoholism, smoking habits, and clinical symptoms was collected. Data of clinical evaluation and investigation were also noted.A total of 95 patients with the diagnosis of alcoholicrelated CP were included in the study. One hundred percent of patients were males. The mean age of the patients at the time of diagnosis was 38.7 (±9.5) years. The average daily alcohol intake was 145.1 (±61.8) g/day. The mean duration of drinking was 14.5 (±7.7) years. Sixty-one percent (58/95) were smokers. Ninetythree patients (97.8 %) presented with abdominal pain. Diabetes mellitus was present in four patients (4.2 %), and steatorrhea was present in six patients (6.3 %). Local complication in the form of pancreatic/ peripancreatic collection, necrosis, or pseudocyst was present in 22 patients (23.1 %). Alcohol-related CLD was present in eight patients of alcohol-related CP (8.4 %). One study reported that the presence of CLD in patients with CP was variable, ranging between 5 % and 30 % [4]. The clinical manifestations, functional parameters, and imaging characteristics of alcoholrelated CLD in patients with alcohol-related CP were also studied. All eight patients had evidence of CLD on abdominal ultrasound and/or color Doppler. Ascites was present in six patients and was found to be low protein and high serum-ascites albumin gradient (SAAG) in all of them. Similar to...

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Chronic Pancreatitis: Complications

Cited by 3 publications

References 91 publications

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

The M-ANNHEIM classification of chronic pancreatitis: introduction of a unifying classification system based on a review of previous classifications of the disease

Chronic liver disease in alcohol-related chronic pancreatitis patients: Does lightning strike twice?

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