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Chronic Pancreatitis
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Progressive, irreversible inflammatory damage to pancreas resulting in parenchymal fibrosis, morphologic changes, and loss of endocrine/exocrine function

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Radiographic Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Gupte AR et al: Chronic pancreatitis. Curr Opin Gastroenterol. 30(5):500-5, 2014
                                            2. Manikkavasakar S et al: Magnetic resonance imaging of pancreatitis: An update. World J Gastroenterol. 20(40):14760-14777, 2014
                                            3. O'Neill E et al: MR imaging of the pancreas. Radiol Clin North Am. 52(4):757-77, 2014
                                            4. Raman SP et al: Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know. Abdom Imaging. 38(6):1360-72, 2013
                                            5. Tirkes T et al: Secretin-enhanced MR cholangiopancreatography: spectrum of findings. Radiographics. 33(7):1889-906, 2013
                                            6. Arikawa S et al: Assessment of chronic pancreatitis: Use of whole pancreas perfusion with 256-slice computed tomography. Pancreas. Epub ahead of print, 2012
                                            7. Zamboni GA et al: Dynamic MDCT of the pancreas: Is time-density curve morphology useful for the differential diagnosis of solid lesions? A preliminary report. Eur J Radiol. 81(3):e381-5, 2012
                                            8. Lu N et al: 64-slice CT perfusion imaging of pancreatic adenocarcinoma and mass-forming chronic pancreatitis. Acad Radiol. 18(1):81-8, 2011
                                            9. Andersson R et al: Pathogenesis of chronic pancreatitis: a comprehensive update and a look into the future. Scand J Gastroenterol. 44(6):661-3, 2009
                                            10. Aoun E et al: Pathways to injury in chronic pancreatitis: decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS ONE. 3(4):e2003, 2008
                                            11. Aoun E et al: Rapid evolution from the first episode of acute pancreatitis to chronic pancreatitis in human subjects. JOP. 8(5):573-8, 2007
                                            12. Fink EN et al: Genetic counseling for nonsyndromic pancreatitis. Gastroenterol Clin North Am. 36(2):325-33, ix, 2007
                                            13. Tamura R et al: Chronic pancreatitis: MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation. Radiology. 238(3):920-8, 2006
                                            14. Park MS et al: Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology. 233(1):234-40, 2004
                                            15. Manfredi R et al: Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology. 224(3):675-82, 2002
                                            16. Matos C et al: MR imaging of the pancreas: a pictorial tour. Radiographics. 22(1):e2, 2002
                                            17. Remer EM et al: Imaging of chronic pancreatitis. Radiol Clin North Am. 40(6):1229-42, v, 2002
                                            18. Varghese JC et al: Value of MR pancreatography in the evaluation of patients with chronic pancreatitis. Clin Radiol. 57(5):393-401, 2002
                                            19. Ichikawa T et al: Duct-penetrating sign at MRCP: usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. Radiology. 221(1):107-16, 2001
                                            20. Kim T et al: Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings. AJR Am J Roentgenol. 177(2):367-71, 2001
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Progressive, irreversible inflammatory damage to pancreas resulting in parenchymal fibrosis, morphologic changes, and loss of endocrine/exocrine function

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Radiographic Findings

                                                            • Ultrasonographic Findings

                                                              • Angiographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Gupte AR et al: Chronic pancreatitis. Curr Opin Gastroenterol. 30(5):500-5, 2014
                                                                                      2. Manikkavasakar S et al: Magnetic resonance imaging of pancreatitis: An update. World J Gastroenterol. 20(40):14760-14777, 2014
                                                                                      3. O'Neill E et al: MR imaging of the pancreas. Radiol Clin North Am. 52(4):757-77, 2014
                                                                                      4. Raman SP et al: Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know. Abdom Imaging. 38(6):1360-72, 2013
                                                                                      5. Tirkes T et al: Secretin-enhanced MR cholangiopancreatography: spectrum of findings. Radiographics. 33(7):1889-906, 2013
                                                                                      6. Arikawa S et al: Assessment of chronic pancreatitis: Use of whole pancreas perfusion with 256-slice computed tomography. Pancreas. Epub ahead of print, 2012
                                                                                      7. Zamboni GA et al: Dynamic MDCT of the pancreas: Is time-density curve morphology useful for the differential diagnosis of solid lesions? A preliminary report. Eur J Radiol. 81(3):e381-5, 2012
                                                                                      8. Lu N et al: 64-slice CT perfusion imaging of pancreatic adenocarcinoma and mass-forming chronic pancreatitis. Acad Radiol. 18(1):81-8, 2011
                                                                                      9. Andersson R et al: Pathogenesis of chronic pancreatitis: a comprehensive update and a look into the future. Scand J Gastroenterol. 44(6):661-3, 2009
                                                                                      10. Aoun E et al: Pathways to injury in chronic pancreatitis: decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS ONE. 3(4):e2003, 2008
                                                                                      11. Aoun E et al: Rapid evolution from the first episode of acute pancreatitis to chronic pancreatitis in human subjects. JOP. 8(5):573-8, 2007
                                                                                      12. Fink EN et al: Genetic counseling for nonsyndromic pancreatitis. Gastroenterol Clin North Am. 36(2):325-33, ix, 2007
                                                                                      13. Tamura R et al: Chronic pancreatitis: MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation. Radiology. 238(3):920-8, 2006
                                                                                      14. Park MS et al: Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology. 233(1):234-40, 2004
                                                                                      15. Manfredi R et al: Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology. 224(3):675-82, 2002
                                                                                      16. Matos C et al: MR imaging of the pancreas: a pictorial tour. Radiographics. 22(1):e2, 2002
                                                                                      17. Remer EM et al: Imaging of chronic pancreatitis. Radiol Clin North Am. 40(6):1229-42, v, 2002
                                                                                      18. Varghese JC et al: Value of MR pancreatography in the evaluation of patients with chronic pancreatitis. Clin Radiol. 57(5):393-401, 2002
                                                                                      19. Ichikawa T et al: Duct-penetrating sign at MRCP: usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. Radiology. 221(1):107-16, 2001
                                                                                      20. Kim T et al: Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings. AJR Am J Roentgenol. 177(2):367-71, 2001