Late outcome after acute pancreatitis: functional impairment and gastrointestinal tract complications.

Functional and morphologic changes that take place in the pancreatic gland after an episode of acute pancreatitis have been the subject of discussion among experts in recent years. At the present time there are enough studies to support the fact that for a certain time if not permanently after acute pancreatitis a variable number of patients continue to show morphologic pancreatic changes in the pancreas and exocrine functional impairment. These changes are clearly seen to be related to the severity and alcoholic etiology of the pancreatitis. There are also indications of possible progression from acute alcoholic pancreatitis to chronic pancreatitis, related to severity and recurrence. It is more probable that it is the first instance of pancreatitis in a pancreas that has previously suffered asymptomatic alcohol-induced impairment. The vascular and gastrointestinal tract complications that make a late appearance after acute pancreatitis, although infrequent, on occasion confronts the patient with a high risk of mortality, especially in cases of perforation and hemorrhage.