Background Mechanism of pain in Chronic Pancreatitis is not fully understood. Recurrent acute inflammation is one of the proposed hypotheses for pain in chronic pancreatitis. The actual incidence and prevalence of ongoing acute inflammation in chronic pancreatitis have been under-noticed in literature. This study aims to examine the prevalence of acute pancreatic inflammation in chronic pancreatitis patients. Methods Fifty patients who underwent surgery for chronic pancreatitis were analyzed. Those with clinical, biochemical or radiological features of acute on chronic pancreatitis were excluded. Intra operative fine needle aspiration cytology was taken from the head and body of pancreas. Pancreatic tissue was sent for histopathological examination in all patients. Results Intraoperative fine needle aspiration cytology from pancreas showed features of acute inflammation in twenty 23 (46%) cases. Biopsy from pancreas showed features of acute inflammation in 12 patients (24%). 30/50 (60%) patients had some features of acute inflammation in either fine needle aspiration cytology or biopsy. Conclusion Significant proportion of patients with chronic pancreatitis has pathological features of acute inflammation in pancreas despite clinical, biochemical and radiological features showing no evidence of acute pancreatitis. Ongoing pathological acute inflammatory process in the pancreas might be a major cause for initiation and progression of chronic fibrosis in chronic pancreatitis.
Pavankumar Vijayaraj, Biju Pottakkat, Raja Kalayarasan, Sandip Chandrasekar, Surinder Kumar Verma