Delay in diagnosing chronic pancreatitis

OBJECTIVESTo determine the time lapse between the onset of symptoms and diagnosis in chronic pancreatitis. To determine influential factors. DESIGNRetrospective PATIENTSAdult patients of both genders (n = 332) diagnosed with chronic pancreatitis between 1965 and 1992. MAIN OUTCOME MEASURESAbnormal secretin-pancreozymin test and plain abdominal X-ray. Supplemented with ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography. RESULTSOverall, diagnosis of chronic pancreatitis was delayed for 62±4 (SEM) months after the onset of symptoms. The disease was detected earliest in alcoholics and patients with pseudocysts after an average delay of 55 months. Delay was longer for non-alcoholics (81 months). The difference was significant. There was no gender bias. It took 8–9 months longer to discover the disease in calcifying than in non-calcifying pancreatitis. Diagnosis occurred sooner in patients with pseudocysts than in those without. The latter two differences were not significant. CONCLUSIONAlthough the ideal diagnostic means have not been established as yet, the long delay in diagnosing chronic pancreatitis in our study indicates that chronic pancreatitis should be considered as a possible cause of upper abdominal pain of unclear aetiology. Early diagnosis of chronic pancreatitis and subsequent treatment would obviously help reduce pain and complications.