Relationship between the presenting symptoms and age at diagnosis in alcoholic and nonalcoholic chronic pancreatitis: analysis of 164 patients.
OBJECTIVE
To study the different forms of presentation, patient age, delay in diagnosis and incidence of calculi in alcoholic and nonalcoholic chronic pancreatitis.


METHODS
We have studied 130 men and 34 women diagnosed as having chronic pancreatitis on the basis of clinical criteria and morphological and/or functional tests.


RESULTS
Alcohol was the most common cause of chronic pancreatitis in men (89.1%) existing a significant difference with respect to women (p < 0.05). The mean age of the patients with alcoholic chronic pancreatitis was 45.6 +/- 11.3 years and that of patients presenting nonalcoholic chronic pancreatitis was 54.5 +/- 11.5 years (p < 0.01), the latter showing a bimodal distribution. The ages of the patients in whom the presenting symptom was abdominal pain and acute inflammatory episodes were 43.9 +/- 12.8 and 45.3 +/- 13.5 years, respectively, significantly lower (p < 0.05) than the age of patients in whom presentation was signaled by the onset of diabetes or diarrhea (53.1 +/- 11.2 and 61.2 +/- 12.9 years, respectively). Statistically significant differences existed in the delay in diagnosis when comparing the patients before and after 1985 (12.3 +/- 14.5 years, range 0 to 50 years, versus 0.42 +/- 0.9 years, range 0 to 5 years; p = 0.005). At diagnosis, 14.3% of the patients whose presenting symptom was acute pancreatitis had pancreatic calculi, versus 42.2% of those who reported abdominal pain as the first indication.


CONCLUSIONS
Alcoholic chronic pancreatitis predominates in men. Nonalcoholic chronic pancreatitis presents two peaks of prevalence. A substantial number of patients may remain pain-free up to diagnosis. Calculi are not uncommon during the initial period of chronic pancreatitis when pain is the presenting symptom, either in the form of isolated episodes of abdominal pain or attacks of acute pancreatitis.
de las Heras Castaño
G
G
Service of Digestive Diseases, Marqués de Valdecilla University Hospital, Santander, Spain.
Sánchez Antolín
G
G
Dueñas Sadornil
C
C
de la Peña García
J
J
Pons Romero
F
F
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000473:pathology*; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000473:pathology*