A comparative study of patients with pancreatic calcification in Sri Lanka

Abstract

INTRODUCTION: Although alcohol abuse is a common cause of pancreatic calcification in the west, a non-alcoholic form called Tropical caicific Pancreatitis (TCP) is recognized in Asian countries.OBJECTIVE: To compare the clinical, biochemical, radiological and endoscopic profiles and success of endotherapy of TCP with Alcoholic Calcific Pancreatitis (ACP). METHODS:Biochemical assay. and ERCPs were performed on 50 patients with pancreatic calcification.There were 28 TCP and 22 ACP in the sample. Mean age of ACP (43.7y SD 8.9) was higher than TCP (37.7 SD 10 p<0/05). ACP was exclusively seen among males.Mean age of onset of pain was lower in the TCP. Nearly 80% of TCP had pain scores more or equal to 7 compared to 54.5% in ACP. Onset of diabetes mellitus in TCP occurred earlier than ACP (34y Vs 40y). Mean serum insulin and duodenal trypsin levels were higher in the TCP patients. On x-ray 85% of TCP had coarse calcium plaques and 71.4% of ACP had speckled plaques. ERCP was successful in nearly 70% of the total sample and 50% underwent stenting. Adequate pain relief was observed in 50% in TCP and 54% in ACP. CONCLUSION:Onset of pain and diabetes mellitus occurred at a younger age in TCP. Although more intraductal plaques were seen in TCP, no difference was observed in the response to endotherapy.