The Pathological Physiology of Pancreatic Inflammation

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Abstract
Older assumptions that the etiology of pancreatitis is generally either mechanical or alcoholic have been unsettled by more recent findings. Biliary tract disease and alcoholism are implicated in only two-thirds of patients with chronic pancreatitis; in the remaining third it is necessary to consider the possibility of more obscure etiological factors such as vascular, metabolic, nutritional, and autoimmune phenomena. This is illustrated by data on the volume, bicarbonate content, and amylase content of pancreatic juice obtained in the secretin test in 6 patients with pancreatitis due to chronic duodenal obstruction as compared with 5 patients with pancreatitis from other causes. Subsistence on a low-protein diet (5 to 10 Gm. of protein per day for one year) in 5 patients caused an increase in amylase concentration in every case.

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