Abstract
A case of rapid progression from acute pancreatitis to chronic calcifying pancreatitis within five years is reportd. The patient, a 23-year-old male, experienced the first attack of pancreatitis at the age of 17 after massive alcohol intake and was clinically diagnosed as acute pancreatitis. He thereafter continued alcohol abuse and attacks of pancreatitis recurred frequently. Three years after the first attack, he was diagnosed as having chronic pancreatitis by endoscopic retrograde pancreatography (ERP), and two years later, calcification developed further. Although we could not confirm whether or not acute pancreatitis, if the first attack was that, developed into chronic pancreatitis our case seemed to be rare because of the rapid progression of the pancreatitis. The total alcohol intake by our patient was a rather less than that generally accepted as the amount causing alcoholic chronic pancreatitis. Nevertheless, there was a pattern of pancreatic calcification like that observed in alcoholics. It was thus assumed that similar changes would be induced in the pancreas even by low doses of alcohol, if the patient was more sensitive to alcohol. It is therefore necessary to establish methods to differentiate etiologies of chronic pancreatitis including the assessment of individual sensitivity to ethanol, and detect changes of chronic pancreatitis that would not be shown by ERP in the early stages. If these became available, we could confirm the pathogensis in this case, and the relations between acute pancreatitis and chronic pancreatitis could be verified.
