/ ABDOMINAL IMAGINGELSEVIER et John F Kennedy Br xe 1800 Php PA 191032999 ABDOMINAL IMAGING, SECOND EDITION say. e7e 0323277980 Copyright© 2017 by Elsevier In. lights reserved. No pt of thi publication yb reproduced or tasted in ay for by any mens lero oF ncn nang potospyingtevoring, oan nrmrton storage ad eel sven, whoa prison in writing from the publish Details om how osc perisn, farther infoertion bout the Publishers permision plc and our arrangement wth organizations suc asthe Copyright Ckarance Center an the Copyright Lining Agency cn be found st our website ember somipermion. ‘Thisbook andthe individual contributions contained int ar protected undr copyright by (ether thn ax ay be noted herein Se Pubher Naties Knowle and best actin thi dare constant char ing. As new serch ad enpsience broaden Previous ition copyrighted 2011, Library of Congress Cataloging-in-Pubicaton Data ‘Names: Sahen, Deshyant V, editor | Sami, Anthony E, editor Tie: Abdominal imaging / [edited by] Dushyant ¥. Saban Anthoay E Sami (Othe ites: Abonninal imaging Sahai) Description: Second edition. | Phlodephia PA : Elsevier. [20171 | Includes ‘iblographical references and index. Metin: LCCN 2016018766 | ISBN’ 9780323377980 hardcover sal. paper) Subjectss| MESH: Digestive Stem Diseaer-diagnass | Diagnostic Immagng-methods | Radiography, abdonsinal | abdomen ultrasonography | Abdomen-radionulie imaging CCassfestion: ICC RCHO4.D52 | NLM WL 141 | DDC 616.3/(75-de23 LC recond available a btpe:ee oe sou DDNEDISTSG nterntional Standard Book Number: 978-9-825-37798-0 Canton Strategist Robin Carter Canton Develpract Specials: Macybsth Thiel abiding Services Manage: Catherine Jackson Potting Rak Es Working together gn Diet: Bian Salsbur AB 6 grow libraries in Printed in China PookAld developing countries ete Last digit Bthe print number: 8 8-7 6 5 4.3.2149 Imaging of Chronic Pancreatitis Etiology Chronic pancreatitis is defined as an ongoing prolonged in- flammatory disease characterized by progressive irreversible structural changes resulting in permanent loss of endocrine and exocrine function. The Cambridge classification of 1983 acknowledged that chronic pancreatitis is typically associated with abdominal pain but occasionally can be painless and may recur.' According to the revised pancreatic classification of pancreatitis from the Marseille symposium of 1984, acute and chronic pancreatitis are very different diseases and acute pancreatitis only rarely leads to chronic pancreatitis.’ Prolonged alcohol abuse is the most common cause (70%) of chronic pancreatitis in the United States. Other causes are familial occurrence with hyperlipidemia, hyperparathyroidism, cystic fibrosis, trauma, cholelithiasis, and pancreas divisum.’ The familial form of pancreatitis, hereditary pancreatitis, is thought to be inherited in an autosomal dominant fashion with variable penetrance. Of patients with chronic pancreatitis, 30% to 40% have no apparent underlying cause and are considered to have idiopathic chronic pancreatitis.‘ Patients with idiopathic chronic pancreatitis have been noted to cluster in a younger group (peak incidence, 15 to 30 years of age) and an older group (peak incidence, 50 to 70 years of age). Autoimmune chronic pancreatitis is an increasingly recognized condition frequently coexisting with other autoimmune diseases such as ‘Sjégren's syndrome and primary sclerosing cholangitis.” An independent effect of tobacco smoking on the development of chronic pancreatitis has been suggested by several epidemiologic studies.° In certain parts of developing regions such as Africa, India, and South America a particular type of chronic pancreatitis occurs in children and adolescents. It is thought to be caused by dietary toxins and micronutrient deficiencies and results in tropical pancreatitis endemic in these regions (Table 49-1).”