Summary
This is a report on five patients who had acute attacks of pancreatitis (three cases complicated by pseudocysts). They all showed pancreatic calcifications on plain abdominal X-ray(n = 5), computed tomography (n = 3), or at postmortem examination (n = 1). Despite calcifications, the exocrine pancreatic function, as tested with the secretin-pancreozymin test and fecal fat analysis, was either normal or returned to normal. The conclusion is that pancreatic calcifications do not indicate severe exocrine pancreatic insufficiency and the necessity for pancreatic enzyme substitution. Calcifications are not necessarily a sign of chronic pancreatitis. They may result rather from scars following acute pancreatitis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ring EJ, Eaton SB Jr, Ferrucci JT, Short WF. Differential diagnosis of pancreatic calcification. Am. J. Roentgenol. 1973; 117: 446–452.
Owens JL Jr, Howard JM. Pancreatic calcification: a late sequel in the natural history of chronic alcoholism and alcoholic pancreatitis. Ann. Surg. 1958; 147: 326–338.
Creutzfeldt W, Fehr H, Schmidt, H. Verlaufsbeobachtungen und diagnostische Verfahren bei der chronisch-rezidivierenden und chronischen Pankreatitis. Schweiz. Med. Wochenschr. 1970; 100: 1180–1189.
Ammann RW, Hammer B, Fumagalli I. Chronic pancreatitis in Zurich, 1963–1972. Clinical findings and follow-up studies of 102 cases. Digestion 1973; 9: 404–415.
Marks IN, Bank S, Barbezat GO. Alkoholpankreatitis: Ätiologie, klinische Formen, Komplikationen. Leber Magen Darm 1976; 6: 257–270.
Kondo T, Hayakawa T, Noda A, Ito K, Yamazaki Y, Iinuma Y, Okumura N, Sakakibara A, Mizuno R, Naruse S. Follow-up study of chronic pancreatitis. Gastroenterol. Jpn. 1981; 16: 46–53.
Toskes PP, Greenberger NJ. Acute and chronic pancreatitis. Disease-a-Month 1983; 29: 1–81.
Lankisch PG, Otto J, Erkelenz I, Lembcke B. Pancreatic calcifications: no indicator of severe exocrine pancreatic insufficiency. Gastroenterology 1986; 90: 617–621.
Creutzfeldt W. Funktionsdiagnostik bei Erkrankungen des exokrinen Pankreas. Verh. Dtsch. Ges. Inn. Med. 1964; 70: 781–801.
Van de Kamer JH, ten Bokkel Huinink H, Weiyers HA. Rapid method for the determination of fat in feces. J. Biol. Chem. 1949; 177: 347–355.
Axon ATR, Classen M, Corrton PB, Cremer M, Freeny PC, Lees WR. Pancreatography in chronic pancreatitis: international definitions. Gut 1984; 25: 1107–1112.
Sarles H, Sahel J, Staub JL, Bourry J, Laugier R. Chronic pancreatitis. In: The Exocrine Pancreas, Howat HT, Sarles H, eds., Saunders, London, 1979; 402–439.
Lankisch PG. Secretin test or secretin-CCK test: gold standard in pancreatic function testing? In: Pancreatitis: Concepts and Classification, Gyr KE, Singer MV, Sarles H, eds., Excerpta Medica, Amsterdam, ICS No. 642, 1984; 247–259.
Heij HA, Obertop H, Van Blankenstein M, ten Kate FW, Westbroek DL. Relationship between functional and histological changes in chronic pancreatitis. Dig. Dis. Sci. 1986; 31: 1009–1013.
Schmitz-Moormann P, Hein J. Altersveränderungen des Pankreasgangsystems und ihre Rückwirkungen auf das Parenchym. Virchows Arch. [A] 1976; 371: 145–152.
Schmitz-Moormann P, Riedel R, Ihm P. Morphometrische Untersuchung der Kaliberschwankungen am normalen Ductus pancreaticus major. Z. GastroenteroL 1981; 19: 299–306.
Schmitz-Moormann P, Himmelmann GW, Brandes JW, Fölsch UR, Lorenz-Meyer H, Malchow H, Soehendra LN, Wienbeck M. Comparative radiological and morphological study of human pancreas. Pancreatitis like changes in postmortem ductograms and their morphological pattern. Possible implication for ERCP. Gut 1985; 26: 406–414.
Otte M. Pankreasfunktionsdiagnostik. Internist 1979; 20: 331–340.
Girdwood AH, Hatefield ARW, Bornman PC, Denyer ME, Kottler RE, Marks IN. Structure and function in noncalcific pancreatitis. Dig. Dis. Sci. 1984; 29: 721–726.
Angelini G, Pederzoli P, Caliari S, Fratton S, Brocco G, Marzoli G, Bovo P, Cavallini G, Scuro LA. Long-term outcome of acute necrohemorrhagic pancreatitis. A 4-year follow- up. Digestion 1984; 30: 131–137.
Begley CG, Roberts-Thomson IC.Spontaneous improvement in pancreatic function in chronic pancreatitis. Dig. Dis. Sci. 1985; 30: 1117–1120.
García-Pugés AM, Navarro S, Ros E, Elena M, Ballesta A, Aused R, Vilar-Bonet J. Reversibility of exocrine pancreatic failure in chronic pancreatitis. Gastroenterology 1986; 91: 17–24.
Ammann RW, Akovbiantz A, Largiader F, Schueler G. Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients. Gastroenterology 1984; 86: 820–828.
Banks PA. Pancreatitis. Plenum, New York, 1979.
Ferrucci JT Jr, Wittenberg J, Black EB, Kirkpatrick RH, Hall DA. Computed body tomography in chronic pancreatitis. Radiology 1979; 130: 175–182.
Guien C. Radiological examination of the pancreas. In: The Exocrine Pancreas, Howat HT, Sarles H, eds., Saunders, New York, 1979; 176–226.
Beyer, D, Köster R. Diagnostischer Wert von Abdomenübersichtsaufnahmen bei akuter Pankreatitis. Fortschr. Röntgenstr. 1980; 132: 9–15.
Kirchner R, Mathias K, Wenz W, Hartung H. Diagnostischer Wert der Thorax- und Abdomen-Übersichtsaufnahmen bei akuter Pankreatitis. Münch. Med. Wochenschr. 1977; 119: 1453–1456.
Stein GN, Kaiser MH, Sarian NN, Finkelstein A. An evaluation of the roentgen changes in acute pancreatitis: correlation with clinical findings. Gastroenterology 1959; 36: 354–361.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lankisch, P.G., Otto, J., Löhr, A. et al. Pancreatic calcifications in patients with normal pancreatic function. Int J Pancreatol 5, 281–293 (1989). https://doi.org/10.1007/BF02924473
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02924473