Painless chronic pancreatitis

Dig Liver Dis. 2020 Nov;52(11):1333-1337. doi: 10.1016/j.dld.2020.08.040. Epub 2020 Sep 10.


Background: Painless chronic pancreatitis (CP) is a rare form of the disease.

Aim: To evaluate the prevalence and the characteristics of this overlooked form of pancreatitis.

Methods: Patients with a diagnosis of CP and absence of pain were selected, excluding patients suffering from autoimmune pancreatitis. Clinical data, imaging features, and exocrine and endocrine function were therefore analyzed.

Results: Among 781 patients observed between 2010 and 2016, 74 patients with painless CP (9.5%) were selected. Mean age at diagnosis was 60.8 (SD 10.8) years. 38(51%) individuals did not report any symptom, 36(49%) were affected by symptoms other than pain. Pancreatic calcifications were diagnosed in 70 patients (95%), main pancreatic duct dilation in 55(74%), and pancreatic atrophy in 39(53%).Thirty-six patients (55%) had severe exocrine pancreatic insufficiency(EPI). Diabetes was observed in 34 out of 72 patients (47%). During a mean follow-up of 2.9 (SD 2.8) years, only a mild pancreatitis was diagnosed in a 71-year old female. No patient underwent endoscopic treatment or surgery, developed pancreatic cancer or died.

Conclusions: In a tertiary center painless CP is observed in 10% of cases, and it is frequently associated with EPI. The probability of onset of pain is very low in a short-term follow-up.

Keywords: Chronic pancreatitis; Diagnosis; Painless; Pancreatic calcifications.

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Calcinosis / diagnostic imaging
  • Calcinosis / epidemiology
  • Calcinosis / etiology*
  • Cholangiopancreatography, Endoscopic Retrograde
  • Diabetes Mellitus / epidemiology
  • Exocrine Pancreatic Insufficiency / diagnosis
  • Exocrine Pancreatic Insufficiency / epidemiology
  • Exocrine Pancreatic Insufficiency / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Italy
  • Male
  • Middle Aged
  • Pain Measurement
  • Pancreatitis, Chronic / complications*
  • Pancreatitis, Chronic / physiopathology*
  • Severity of Illness Index
  • Tertiary Care Centers
  • Time Factors
  • Tomography, X-Ray Computed