Diagnostic criteria for pancreatogenic abdominal pain due to chronic pancreatitis

  Pancreatogenic abdominal pain is one of the symptoms of chronic pancreatitis (chronic pancreatitis), which is a persistent and permanent damage of pancreatic tissue and function caused by various factors. The pancreatic gland shows different degrees of alveolar atrophy, pancreatic duct deformation, fibrosis and calcification, and different degrees of pancreatic exocrine and endocrine dysfunction, clinically manifested as abdominal pain, diarrhea or steatorrhea, wasting and malnutrition and other symptoms of pancreatic insufficiency. Typical chronic pancreatitis is relatively rare in China, and it is difficult to confirm the diagnosis.  The diagnostic criteria for pancreatogenic abdominal pain caused by chronic pancreatitis: (1) The presence of pancreatic stones in the pancreatic tissue on abdominal ultrasound.  (2) CT calcification in the pancreas, confirming the presence of pancreatic stone.  (3) ERCP: irregular dilatation and uneven distribution of the pancreatic duct and its branches in the pancreatic tissue; partial or complete obstruction of the main pancreatic duct, containing pancreatic stones or protein emboli.  (4) Secretion test: decreased secretion of bicarbonate with decreased secretion or excretion of pancreatic enzymes.  (5) Histological examination: tissue section shows destruction and reduction of pancreatic exocrine tissue and interlobular irregular fibrosis, but interlobular fibrosis is not unique to chronic pancreatitis.  (6) Ductal epithelial hyperplasia or atypical hyperplasia, cyst formation.