The clinical manifestations of chronic pancreatitis may be quite varied, ranging from a debilitating disease associated with excruciating pain and pancreatic exocrine and endocrine insufficiencies, to a relatively indolent course with intermittent episodes of abdominal discomfort. In the Western world, the majority of cases are due to chronic and excessive alcohol ingestion and to idiopathic forms of the disease. Additional causes may include trauma, hypercalcemia, cholelithiasis, pancreatic duct obstruction, hypertriglyceridemia, cystic fibrosis, hereditary factors, and congenital abnormalities. In some parts of the world, poorly understood nutritional dysfunctions contribute to a form of chronic pancreatitis in which pancreatic calcifications predominate. This review focuses on the natural history of chronic pancreatitis, an update on treatment modalities, new insights on the molecular alterations that occur in this condition, and the potential relationship between chronic pancreatitis and pancreatic cancer.
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