DELAY IN DIAGNOSING CHRONIC-PANCREATITIS

Objectives: To determine the time lapse between the onset of symptoms and diagnosis in chronic pancreatitis. To determine influential factors. Design: Retrospective Patients: Adult patients of both genders (n = 332) diagnosed with chronic pancreatitis between 1965 and 1992. Main outcome measures: Abnormal secretin-pancreozymin test and plain abdominal X-ray. Supplemented with ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography. Results: Overall, 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. Conclusion: Although 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.