Understanding chronic pancreatitis

  (chronic pancreatitis) is progressive damage to the pancreatic parenchyma (refers to a series of local and systemic multi-organ damage caused by necrosis, hemorrhage and fat necrosis of the pancreatic parenchyma) and fibrosis, often accompanied by calcification, pseudocysts and islet cell reduction or atrophy, due to biliary tract disease or alcoholism and other factors. The main manifestations are abdominal pain, emaciation, malnutrition, diarrhea or steatorrhea, and later abdominal mass, jaundice and diabetes. It is generally believed that biliary tract diseases or alcoholism cause pancreatic inflammation to recur and pass in a chronic manner, eventually leading to chronic pancreatitis. Secondly, inflammatory lesions of the intestinal tract, cirrhosis, malnutrition, thiazole drugs, etc. can also induce the disease, and there are still many patients with unknown etiology.  The extent and severity of the lesions vary, with the head of the pancreas being the most common. The pancreatic gland is seen nodular with increased stiffness, fibrous tissue hyperplasia and calcium deposits on the naked eye. Microscopically, we can see perifollicular and interalveolar fibrous hyperplasia or extensive fibrosis of the pancreas, atrophy and disappearance of the alveoli and islet tissue, squamous metaplasia of the columnar epithelium of the pancreatic duct; lymphocytes and plasma cells infiltrate the interstitium. In a few cases of chronic pancreatitis, the epithelial cells of the pancreas are abnormally proliferated and have the possibility of cancer. Chronic pancreatitis can be complicated by pseudocysts, splenic vein thrombosis, pancreatogenic peritoneal, pericardial, and pleural effusions, peptic ulcers, and pancreatic cancer.  The initial phase is alternating between relatively asymptomatic phase and exacerbation phase; the late phase is mainly the manifestation of pancreatic insufficiency. Most of the late stage deaths are due to complications. Such as failure, diabetes mellitus, biliary septic infection, etc. A few may evolve into pancreatic cancer.