Chronic pancreatitis: medical aspects.

TwO DISTINCT features characterize the pathological entity of chronic pancreatitis, acinar destruction and fibrous tissue formation, the final stage of which is a destroyed and densely sclerotic pancreas. Some degree of dilatation and stricture of the pancreatic ducts is often present, in some cases associated with pancreatic calculi. Sarles and his colleagues (Sarles, Muratore & Sarles, 1961; Sarles et al., 1965) have shown that both aetiologically and pathologically chronic pancreatitis differs from and is a most infrequent sequel to acute pancreatitis. Not only can a pathological distinction between these entities be made but the prognosis differs in the two since in the absence of complications such as pseudocyst or abcess restitution of both structure and function frequently follow elimination of the cause in acute pancreatitis whereas chronic pancreatitis is a self perpetuating and often progressive disease. Howat (1966) has published a working classification of pancreatitis (Table 1).