Pancreatitis crónica

The etiopathogenesis of chronic pancreatitis is not well characterized. Smoking, autoimmunity, and the presence of mutations in specific genes have been demonstrated to be important associated etiological factors. Endoscopic ultrasonography, with or without pancreatic aspiration-biopsy, has good sensitivity and specificity. In patients with chronic pancreatitis, abdominal pain may be a crippling symptom. Antiinflammatory radiotherapy may mitigate the symptoms and avoid the use of mutilating surgery. In pancreatic failure, pancreatic enzyme replacement therapy should be optimized by individualizing the dose. Autoimmune forms of pancreatitis are under-diagnosed in Europe. Corticosteroid therapy is highly effective but its interruption leads to frequent recurrences; in this context maintenance therapy with azathioprine may be useful.