[Diagnosis of chronic pancreatitis]

Abstract

Chronic pancreatitis is typically characterized by clinical (abdominal pain, steatorrhea, loss of body weight), morphological (calcifications, dilated ductus pancreaticus) as well as functional (maldigestion, diabetes mellitus) parameters. Since the diagnosis of chronic pancreatitis is hampered by the inavailability of early histological confirmation, it is therefore based on morphological (ultrasound, ERP, EUS, CT) and functional (faecal elastase) criteria. Due to the poor correlation between morphological and functional parameters in the early phase of the disease, both are complementary at this stage. While the diagnosis of severe cases of chronic pancreatitis with steatorrhea is hardly a challenge in clinical practice, the differential diagnostic evaluation of mild and moderate cases remains a major clinical problem. ERP remains to be the most sensitive morphological procedure, while determination of faecal elastase is the most sensitive and specific "tubeless" pancreatic function test available today and in the future prove to be rapid, easy to handle and highly practicable in clinical routine.