Schmerzentstehung bei chronischer pankreatitis

Background: Although abdominal pain is the most common symptom of chronic pancreatitis, its causes and pathophysiology remain poorly understood. Methods: The pain hypotheses in chronic pancreatitis are reviewed. Results: It seems reasonable to assume that pancreatic pain in chronic pancreatitis has many causes. Several pain hypotheses have been passed including a) focal acute inflammation of the pancreas, b) increased pressure within pancreatic ducts and/or parenchyma and c) extrapancreatic causes including common bile duct stenosis and duodenal stenosis. However, none of them provides a complete explanation. Conclusions: Recent studies report alterations of pancreatic nerves and a close interaction of pancreatic nerves with inflammatory cells as a new pathophysiological concept of pain in chronic pancreatitis. However, the significance of these findings have to be evaluated in further studies.