[Chronic pancreatitis--etiological classifications and diagnostic criteria]

Current etiological classifications divide chronic pancreatitis into a toxo-nutritive form where the main agent is alcohol, and an idiopathic genetically induced form, an auto-immune form, and a recidivistic and obstructive form. It is clear that the different etiologies of the illness are associated with different histological findings. Knowledge of these is vitally important for targeted therapy and assessment of the progress of the disease. Even though chronic pancreatitis is still defined as a chronic, longstanding progressive process of fibrosis of the gland, it has been shown that precisely due to histological differences in the morphology of the gland, the chronic autoimmune form behaves completely differently during corticoid therapy than the alcohol-induced form or the obstructive form. It seems that in the near future it will be necessary to change the definition of the illness as we know it today and change the existing algorithms for diagnosis and subsequent therapy.