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  • Title: Painless chronic pancreatitis.
    Author: Amodio A, De Marchi G, de Pretis N, Crinò SF, D'Onofrio M, Gabbrielli A, Ciccocioppo R, Frulloni L.
    Journal: Dig Liver Dis; 2020 Nov; 52(11):1333-1337. PubMed ID: 32921601.
    Abstract:
    BACKGROUND: Painless chronic pancreatitis (CP) is a rare form of the disease. AIM: To evaluate the prevalence and the characteristics of this overlooked form of pancreatitis. METHODS: Patients with a diagnosis of CP and absence of pain were selected, excluding patients suffering from autoimmune pancreatitis. Clinical data, imaging features, and exocrine and endocrine function were therefore analyzed. RESULTS: Among 781 patients observed between 2010 and 2016, 74 patients with painless CP (9.5%) were selected. Mean age at diagnosis was 60.8 (SD 10.8) years. 38(51%) individuals did not report any symptom, 36(49%) were affected by symptoms other than pain. Pancreatic calcifications were diagnosed in 70 patients (95%), main pancreatic duct dilation in 55(74%), and pancreatic atrophy in 39(53%).Thirty-six patients (55%) had severe exocrine pancreatic insufficiency(EPI). Diabetes was observed in 34 out of 72 patients (47%). During a mean follow-up of 2.9 (SD 2.8) years, only a mild pancreatitis was diagnosed in a 71-year old female. No patient underwent endoscopic treatment or surgery, developed pancreatic cancer or died. CONCLUSIONS: In a tertiary center painless CP is observed in 10% of cases, and it is frequently associated with EPI. The probability of onset of pain is very low in a short-term follow-up.
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