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Chronic Pancreatitis

R. F. JONES, M.D.; R. CLEMENTS, M.D.; C. C. PEARSON, M.D.; L. D. HILL, M.D.; C. S. STONE Jr., M.D.
AMA Arch Intern Med. 1960;105(2):320-323. doi:10.1001/archinte.1960.00270140142017.
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Introduction  This exhibit was prepared to present the practical aspects of the management of pancreatitis. Etiologic factors based on the pathophysiology of the disease are listed, and some are graphically illustrated. Pertinent clinical signs and symptoms and the important diagnostic tests are outlined. Finally the medical and surgical management of pancreatitis is reviewed.

Pathogenesis and Etiology  Repeated episodes of pancreatitis, either edematous or hemorrhagic, lead to the chronic disease state. Occasionally, one episode of fulminant hemorrhagic pancreatitis may be followed by progressive pancreatic fibrosis and calcification with resultant pancreatic insufficiency.Pancreatitis is a disease of diverse etiology. From a practical standpoint, most cases are initiated by continued exocrine secretion in the presence of pancreatic ductal obstruction. The majority of cases are associated with biliary tract disease and/or alcoholism.

Biliary Tract Disease  A high percentage of patients with pancreatitis have associated biliary tract disease. Pancreatic ductal obstruction can occur in the


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