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World J Gastroenterol. Feb 21, 2008; 14(7): 995-998
Published online Feb 21, 2008. doi: 10.3748/wjg.14.995
Is acute recurrent pancreatitis a chronic disease?
Alberto Mariani, Pier Alberto Testoni
Alberto Mariani, Pier Alberto Testoni, Division of Gastroen-terology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University-Scientific Institute San Raffaele, Milan, Italy
Correspondence to: Alberto Mariani, MD, Division of Gastroenterology and Gastrointestinal Endoscopy, Scientific Institute San Raffaele, Via Olgettina 60, Milano 20132, Italy. mariani.alberto@hsr.it
Telephone: +39-2-26432756
Fax: +39-2-2152559
Received: August 31, 2007
Revised: September 8, 2007
Published online: February 21, 2008
Abstract

Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation, hereditary and obstructive pancreatitis seem an acute disease that progress to chronic pancreatitis, likely as a consequence of the activation and proliferation of pancreatic stellate cells that produce and activate collagen and therefore fibrosis. From the diagnostic point of view, in patients with acute recurrent pancreatitis Endoscopic ultrasound (EUS) seems the more reliable technique for an accurate evaluation and follow-up of some ductal and parenchymal abnormalities suspected for early chronic pancreatitis.

Keywords: Classification of pancreatitis; Acute recurrent pancreatitis; Chronic pancreatitis; Alcoholic pancreatitis; Pancreatic stellate cells