Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 537

Chronic pancreatitis is a progressive inflammatory condition that leads to histological changes, including an increase in intralobular fibrous tissue, atrophy of the acini, and a chronic inflammatory infiltrate.¹⁵ Macroscopically, ductal changes can occur, mainly ductal irregularity with intermittent strictures and dilatation. Calcifications and pancreatic atrophy may also be present (Figure 21.2). In clinical practice, the diagnosis of chronic pancreatitis relies on a combination of symptoms, pancreatic function testing, and morphological appearance of the pancreas, rather than biopsy confirmation.

Figure 21.2 Atrophied pancreas with dilated, irregular pancreatic duct and intraductal stone.

In the United States, the prevalence of chronic pancreatitis is 40–50 per 100,000 population.¹⁶ The incidence of chronic pancreatitis in the elderly is uncertain, but it is unusual for symptomatic chronic pancreatitis to be diagnosed for the first time after the age of 65. Post‐mortem examinations reveal that pancreatic stones/calcifications occur in ∼15% of patients over the age of 90 and that changes of chronic pancreatitis are seen. The significance of these findings is uncertain as there may be no correlation with clinical disease.¹⁴