Pathogenesis etiology-chronic pancreatitis
(Gastro 2013;144:1292; JAMA 2019;322:2422)
- Often recurrent acute attacks → inflam infiltrate → fibrosis → loss of exocrine & endocrine tissue. Pancreatic insufficiency (DM, fat/protein malabsorption) when 90% panc fxn lost.
Classification of Chronic Pancreatitis: The TIGAR-O System
- TIGAR-O: Toxins (60-80% due to EtOH; smoking), Idiopathic, Genetic (PRSS1, SPINK1, CFTR, CTRC, CASR), Autoimmune, Recurrent panc., Obstruction