| Popis: |
To the clinician, the fibrosis of chronic pancreatic pancreatitis appears relentless and unregulated. To an extent this is a feature of the natural history of the disease. Although the presentations of our patients vary, some with episodes of acute pancreatitis; some with chronic pain and others with exocrine and endocrine failure; however, all present with established fibrosis. Whilst we may witness the progression of this disease over many years we do not see the early stages. The reasons for this are both anatomical and physiological; by comparison with the liver or kidney, the pancreas is relatively difficult to image and biopsy, and there are no routine blood tests to mark the early stages of dysfunction. As a result our understanding of the processes initiating and driving fibrosis in the pancreas is relatively poor. However, there are some clues. |
