Bhasin Deepak K, Singh Gursewak, Rana Surinder S, Chowdry Shoket M, Shafiq Nusrat, Malhotra Samir, Sinha Saroj K, Nagi Birinder
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Clin Gastroenterol Hepatol. 2009 May;7(5):594-9. doi: 10.1016/j.cgh.2009.01.009.
BACKGROUND & AIMS: Tropical pancreatitis, a form of idiopathic chronic pancreatitis (ICP) with unique features, has been described in South and North India. We investigated the clinical profile of ICP patients in North India.
Detailed demographic data were recorded; hematological and biochemical analyses were performed on samples from 155 patients (mostly from North India) who had been diagnosed with chronic pancreatitis. Ultrasonography and computed tomography were performed on all patients. Magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, glucose tolerance tests, and fecal fat studies were performed on some patients. Patients were divided into groups based on early- or late-onset ICP (before or after 35 years of age).
ICP was reported in 41.3% of patients and alcoholic chronic pancreatitis in 38.1%. The mean age of ICP patients was 33.0 +/- 13.0 years and the mean duration of symptoms at the time of presentation was 40.2 +/- 34.4 months. Pain was the dominant symptom in patients with early- (95.1%) and late-onset (100%) ICP; pseudocyst was the most common local complication. Diabetes was observed in 17.1% of patients with early-onset ICP and 34.8% with late-onset ICP. Pancreatic calcification was noted in 46.3% of patients with early-onset and 47.8% with late-onset ICP. Pseudocyst and segmental portal hypertension occurred more frequently in non-calcific ICP, whereas diabetes mellitus and abnormal fecal fat excretion occurred more frequently in patients with calcific ICP.
In North India, ICP differs from the classical tropical pancreatitis described in the literature. It is associated with a higher prevalence of pain and lower frequencies of diabetes, calcification, and intraductal calculi.
热带胰腺炎是特发性慢性胰腺炎（ICP）的一种形式，具有独特特征，在印度南部和北部均有报道。我们对印度北部ICP患者的临床特征进行了调查。
记录详细的人口统计学数据；对155例（大多数来自印度北部）被诊断为慢性胰腺炎的患者样本进行血液学和生化分析。对所有患者进行超声检查和计算机断层扫描。对部分患者进行磁共振胰胆管造影、内镜逆行胰胆管造影、葡萄糖耐量试验和粪便脂肪研究。根据ICP发病早晚（35岁之前或之后）将患者分组。
41.3%的患者为ICP，38.1%为酒精性慢性胰腺炎。ICP患者的平均年龄为33.0±13.0岁，就诊时症状的平均持续时间为40.2±34.4个月。疼痛是早发型（95.1%）和晚发型（100%）ICP患者的主要症状；假性囊肿是最常见的局部并发症。早发型ICP患者中17.1%出现糖尿病，晚发型ICP患者中34.8%出现糖尿病。早发型ICP患者中46.3%有胰腺钙化，晚发型ICP患者中47.8%有胰腺钙化。假性囊肿和节段性门静脉高压在非钙化性ICP中更常见，而糖尿病和粪便脂肪排泄异常在钙化性ICP患者中更常见。
在印度北部，ICP与文献中描述的经典热带胰腺炎不同。它与更高的疼痛发生率以及更低的糖尿病、钙化和导管内结石发生率相关。
