Tropical Chronic Pancreatitis

Mohan, Viswanathan; Premalatha, G.; Pitchumoni, C. S.

doi:10.1097/00004836-200304000-00012

Cited by 68 publications

(53 citation statements)

References 65 publications

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“…Thus, this particular form of the disease was named "tropical pancreatitis". Subsequent studies from India and Africa confirmed this finding as was reported in the review article published by Mohan et al [22] in 2003.…”

Section: Introductionsupporting

confidence: 63%

Etiology of chronic pancreatitis: Has it changed in the last decade?

Pezzilli¹

2009

WJG

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T h e e v i d e n c e f r o m r e c e n t s u r ve y s o n c h r o n i c pancreatitis carried out around the world shows that alcohol remains the main factor associated with chronic pancreatitis, even if at a frequency lower than that reported previously. It has further confirmed that heavy alcohol consumption and smoking are independent risk factors for chronic pancreatitis. Autoimmune pancreatitis accounts for 2%-4% of all forms of chronic pancreatitis, but this frequency will probably increase over the next few years. The rise in idiopathic chronic pancreatitis, especially in India, represents a black hole in recently published surveys. Despite the progress made so far regarding the possibility of establishing the hereditary forms of chronic pancreatitis and the recognition of autoimmune pancreatitis, it is possible that we are more inaccurate today than in the past in identifying the factors associated with chronic pancreatitis in our patients.

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Section: Introductionsupporting

confidence: 63%

Etiology of chronic pancreatitis: Has it changed in the last decade?

Pezzilli¹

2009

WJG

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“…Tropical pancreatitis (TP) is a form of idiopathic CP seen in tropical Asia and Africa, characterized by abdominal pain, intraductal pancreatic calculi, and diabetes mellitus in young, nonalcoholics subjects (17). Augustine and Ramesh (1) reported 22 pancreatic cancers among 266 patients with TP over an 8-yr period (8.3%).…”

Section: Cp Increases the Risk For Pancreatic Cancermentioning

confidence: 99%

Inflammation and Cancer V. Chronic pancreatitis and pancreatic cancer

Whitcomb

2004

American Journal of Physiology-Gastrointestinal and Liver Physi

176

125

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Pancreatic inflammation appears to increase the risk of pancreatic cancer. This observation is striking in the hereditary pancreatitis kindreds but also occurs in alcoholic, idiopathic, and tropical chronic pancreatitis and cystic fibrosis. However, the mutations associated with hereditary pancreatitis or cystic fibrosis are not found in sporadic pancreatic adenocarcinomas, suggesting that the effects are indirect by causing recurrent pancreatitis and chronic inflammation. The process of mutation accumulation and clonal expansion that is required for development of invasive pancreatic adenocarcinoma must therefore be accelerated in chronic pancreatitis to account for the high incidence of pancreatic cancer in these patients.

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“…ACP was defined as CP associated with the consumption of alcohol greater than 80 gms/d for at least 5 years with history of recurrent acute CP and features of CP on ultrasonogram (USG) or contrast enhanced computed tomography (CECT) abdomen [9] . A diagnosis of TCP was considered in individuals belonging to younger age [2,10] , teetotaler with the presence of large intraductal calculi, with or without diabetes and/or steatorrhea.…”

Section: Methodsmentioning

confidence: 99%

“…Alcoholic chronic pancreatitis (ACP) is the commonest type in the western world accounting for 80% of patients [1] , whereas in the tropics there is a distinct form of non alcoholic type of CP called tropical calcific pancreatitis (TCP). The features of TCP include younger age of onset, presence of large intraductal calculi, an accelerated course of disease leading to end points of diabetes or steatorrhea and a high susceptibility to pancreatic cancer [2] . The most common cause of a head mass in CP is inflammatory and occurs as a result of defective restitution after recurrent attacks of acute pancreatitis [3] .…”

Section: Introductionmentioning

confidence: 99%

Predictors of malignancy in chronic calcific pancreatitis with head mass

Perumal

Palaniappan²,

Sa³

et al. 2013

WJGS

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AIM:To prospectively analyse the clinical, biochemical and radiological characteristics of the mass lesions arising in a background of chronic calcific pancreatitis (CCP). METHODS:Eighty three patients, who presented with chronic pancreatitis (CP) and a mass lesion in the head of pancreas between February 2005 and December 2011, were included in the study. Patients who were identified to have malignancy underwent Whipple' s procedure and patients whose investigations were suggestive of a benign lesion underwent Frey's procedure. Student t -test was used to compare the mean values of imaging findings [common bile duct (CBD), main pancreatic duct (MPD) size] and laboratory data [Serum bilirubin,] between the groups. Receiver operating characteristic curve (ROC curve) analysis was done to calculate the cutoff valves of serum bilirubin, CA 19-9, MPD and CBD size. The sensitivity, specificity, positive predictive valve (PPV) and negative predictive value (NPV) were calculated using these cut off points. Multivariate analysis was performed using logistic regression model. RESULTS:The study included 56 men (67.5%) and 27 women (32.5%). Sixty (72.3%) patients had tropical calcific pancreatitis and 23 (27.7%) had alcohol related CCP. Histologically, it was confirmed that 55 (66.3%) of the 83 patients had an inflammatory head mass and 28 (33.7%) had a malignant head mass. The mean age of individuals with benign inflammatory mass and those with malignant mass was 38.4 years and 45 years respectively. Significant clinical features that predicted a malignant head mass in CP were presence of a head mass in CCP of tropics, old age, jaundice, sudden worsening abdominal pain, gastric outlet obstruction and significant weight loss (P ≤ 0.05). The ROC curve analysis showed a cut off value of 5.8 mg/dL for serum bilirubin, 127 U/mL for CA 19-9, 11.5 mm for MPD size and 14.5 mm for CBD size. CONCLUSION:Elevated Serum bilirubin and CA 19-9, and dilated MPD and CBD were useful in predicting malignancy in patients with CCP and head mass.

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Tropical Chronic Pancreatitis

Cited by 68 publications

References 65 publications

Etiology of chronic pancreatitis: Has it changed in the last decade?

Etiology of chronic pancreatitis: Has it changed in the last decade?

Inflammation and Cancer V. Chronic pancreatitis and pancreatic cancer

Predictors of malignancy in chronic calcific pancreatitis with head mass

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