Opinion from Portugal

Abstract

Do chronic pancreatitis patients all have the same disease, or there are different clinical presentations of chronic pancreatitis? Although suggestive, this is a very intriguing and challaging question. The clinical approach is possible, although sometimes difficult. However, some etiological aspects are still unclear, and the pathogenesis is still controversial. Therefore, to consider any concept on a clinical basis it is necessary to review these two last parameters. For pratical purposes, let us consider chronic pancreatitis as either alcoholic or nonalcoholic. Alcoholism, together with biliary biliary tract diseases are the two major causes, and chronic alcohol abuse it is thought to cause pancreatitis in 40% –80% of patients. Chronic alcoholic pancreatitis has been differentiated into calcific and noncalcific forms. In the tropical areas a nonalcoholic form, appearing in young subjects, is called tropical pancreatitis. The prevalence of other factors is statistically négligeable compared with the main causes.