Manes G, Kahl S, Glasbrenner B, Malfertheiner P
Department of Gastroenterology, Hepatology and Infectious Disease, Otto-von-Guericke University, Magdeburg, Germany.
Ann Ital Chir. 2000 Jan-Feb;71(1):23-32.
Chronic pancreatitis is a dynamic disease characterized on one side by a progressive destruction of the pancreatic parenchyma and change in the architecture of the gland and on the other by the impairment of its function. Diagnosis of chronic pancreatitis may be a quite easy or a very difficult attempt according to the severity and evolutive stage of disease. In fact, while most patients presents with a typical history of alcohol abuse, recurrent abdominal pain and steatorrhea, in the late stage of disease it is not rare to see patients with symptoms and signs which may be not typical for pancreatitis. A large number of morphological and functional methods has been developed to allow an easy and early diagnosis of disease. However, while in the advanced stages of disease, where pancreatic insufficiency, calcifications, or pseudocysts are present, diagnosis is easy and most of the procedures show high sensitivity and specificity, in the early disease the degree of pancreatic dysfunction and structural change are too small to be detected by current methods. The present article aims to evaluate the different morphological and functional methods with their advantages and shortcomings, as well as to establish their role in the diagnostic assessment of chronic pancreatitis.
慢性胰腺炎是一种动态疾病，一方面其特征为胰腺实质的进行性破坏和腺体结构的改变，另一方面为胰腺功能受损。根据疾病的严重程度和发展阶段，慢性胰腺炎的诊断可能非常容易，也可能极具挑战性。事实上，虽然大多数患者有典型的酗酒史、反复腹痛和脂肪泻，但在疾病晚期，出现胰腺炎非典型症状和体征的患者并不少见。为了实现疾病的轻松早期诊断，人们已经开发了大量形态学和功能学方法。然而，在疾病晚期，当出现胰腺功能不全、钙化或假性囊肿时，诊断很容易，大多数检查方法都具有很高的敏感性和特异性；而在疾病早期，胰腺功能障碍和结构改变的程度太小，目前的方法无法检测到。本文旨在评估不同的形态学和功能学方法及其优缺点，并确定它们在慢性胰腺炎诊断评估中的作用。
