Chronic pancreatitis

In the past year, there has been at least one important clinical paper that sheds light on the character and natural history of painful chronic pancre atitis, which has important clinical implications. In addition, several nov el mutations have been described in the cationic trypsinogen gene in patien ts with hereditary pancreatitis. The mechanism by which these mutations cau se pancreatic disease remains speculative. The diagnosis of early chronic p ancreatitis is controversial. A novel noninvasive pancreatic function test (measurement of postprandial APOB-48) was reported but is unlikely to be a sensitive test of pancreatic function. Pancreatic fibrosis is frequently se en in alcoholics without chronic pancreatitis, and this makes it difficult to interpret the findings on endoscopic ultrasonogram. Recent studies highl ight the difficulty in abolishing pancreatic steatorrhea. Recently fibrosin g colonopathy in adult patients has been reported. Extracorporeal shockwave lithotripsy combined with endoscopic therapy failed to benefit patients wi th calcific chronic pancreatitis. Curr Opin Gastroenterol 2000, 16:414-418 (C) 2000 Lippincott Williams & Wilkins, Inc.