Clinical course of alcoholic pancreatitis

Aim. To study a natural course of alcoholic pancreatitis (AP). Material and methods. Follow-up clinical, laboratory and radiation examinations were made of 170 patients with alcoholic pancreatitis. Exocrine secretion of the pancreas was assessed by secretin-pancreozymin test. Morphological signs of pancreatitis were studied in patients who had died of pancreatic cancer. Results. In 24% of patients A P manifested with acute attack. In 76% it was preceded with weak clinical symptoms. AP ran with recurrences and complications (93.5 and 38%, respectively). Most frequently AP was complicated with pseudotumorous pancreatitis, calcinosis and pancreatic pseudocysts. Pancreatic secretion was suppressed in 87% patients though clinically it was evident only in 12% cases. Autopsy cases of pancreatic cancer carried morphological markers of chronic pancreatitis. Conclusion. Various clinical forms of AP represent stages of its development: early symptoms, recurrences, complications and decompensated failure of the pancreatic function. The presence of pancreatitis in patients with pancreatic cancer causes difficulties in differential diagnosis between these diseases.