Chronic pancreatitis in the old age

Czech version

Authors: M. Berková; Z. Berka; E. Topinková
Published in: Geriatrie a Gerontologie 2015, 4, č. 2: 81-86
Category: Review Article

Overview

Chronic pancreatitis (ChP) is a progressive inflammatory process, characterized by successive fibrotization of the gland. The incidence of chronic pancreatitis in the Czech Republic is almost at 8 new cases/100 000 inhabitants/year. The genesis of chronic pancreatitis after sixty years of age is rare, in most cases the disease begins in earlier life periods. The aetiology factors of ChP are summarized in the TIGAR-O classification. The most common cause of chronic pancreatitis is alcoholism. In the case of late onset of the disease in elderly people it is necessary to think of biliary or autoimmune aetiology, but often the aetiology remains unclear. The abdominal pain is frequent in younger people, but it may not dominate in older patients if sensitive neural terminals are destroyed. The main signs of pancreatic insufficiency are malabsorption and malnutrition, in advanced stages diabetes mellitus tends to develop as well. Routine laboratory examination shows little sensitivity and specificity in ChP. The most important role in diagnostics is played by imaging techniques (computed tomography and nuclear magnetic resonance imaging). Besides conservative treatment, the newer invasive procedures, or in some indicated cases surgery, are available as well.

Keywords:
chronic pancreatitis – TIGAR-O classification – steatorrhoea – malnutrition – pancreatine

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