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Overview of the complications of chronic pancreatitis

Author
Steven D Freedman, MD, PhD
Section Editor
David C Whitcomb, MD, PhD
Deputy Editor
Shilpa Grover, MD, MPH

INTRODUCTION

Chronic pancreatitis is an inflammatory condition that results in permanent structural changes in the pancreas, which can lead to impairment of exocrine and endocrine functions. This topic will review the complications of chronic pancreatitis. The clinical manifestations, diagnosis, and management of chronic pancreatitis are discussed in detail separately. (See "Clinical manifestations and diagnosis of chronic pancreatitis in adults".)

PSEUDOCYSTS

Pseudocysts develop in approximately 10 percent of patients with chronic pancreatitis. They can be induced by an acute exacerbation of pancreatitis or occur as a result of ductal disruption. Pseudocysts are mature fluid collections, have a well-defined wall, and do not contain solid material or pancreatic necrosis. Most pseudocysts communicate with the pancreatic ductal system and contain high concentrations of digestive enzymes. The walls of pseudocysts are formed by adjacent structures such as the stomach, transverse mesocolon, gastrocolic omentum, and pancreas (image 1). (See "Walled-off pancreatic fluid collections (including pseudocysts)", section on 'Definitions'.)

Clinical manifestations — Most pseudocysts are asymptomatic. They can, however, produce a wide range of clinical manifestations depending upon the location and extent of the fluid collection.

Expansion of the pseudocyst can produce abdominal pain, duodenal or biliary obstruction, vascular occlusion, or fistula formation into adjacent viscera, the pleural space, or pericardium. (See 'Bile duct or duodenal obstruction' below.)

Spontaneous infection with abscess formation.

                       

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Literature review current through: Aug 2016. | This topic last updated: May 5, 2016.
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