[Definition, diagnosis and differential diagnostics of chronic pancreatitis].

Chronic pancreatitis is characterized by irreversible morphological alterations in exocrine and endocrine tissue, combining inflammation and fibrosis. But the usual lack of histological evidence is a problem with this definition. The presentation of chronic pancreatitis is varied: fortuitous discovery, acute or chronic painful manifestations, diarrhoea due to exocrine pancreatic insufficiency, diabetes. CT and MRI are the 2 key procedures for the CP diagnosis and the differential diagnosis of pancreatic adenocarcinoma and papillary and mucinous intraductal tumors. Endoscopic ultrasound is useful for the diagnosis of early forms and for the differential diagnosis of a pseudotumoral focal form. Once the diagnosis of chronic pancreatitis is confirmed, the patient's management includes an exhaustive work-up to search for the cause (alcohol, tobacco, genetics, autoimmune, radiation, ischemic, etc.) and the evaluation of complications (pain, exocrine pancreatic insufficiency, diabetes, cholestasis, cancer).