Pancreatic fibrosis in chronic alcoholics and nonalcoholics without clinical pancreatitis

A postmortem study was undertaken to determine the prevalence and nature of pancreatic injury in chronic alcoholics with no clinical pancreatitis. The material for this postmortem study was obtained from 101 entire pancreata. From five sites in each of the pancreata, sections were obtained and evaluated by two pathologists who used a 0-3 numerical grading of fibrosis. Forty-seven percent of the alcoholics had diffuse fibrosis of all five segments, in contrast to only 29% of the nonalcoholics. No fibrosis was present in 32% of the alcoholics and 56% of the nonalcoholics (p less than 0.05). The nonalcoholics tended to show an increase with age in the proportion of cases having fibrosis. The data suggest that there is ongoing pancreatic damage in chronic alcoholics before the onset of clinical pancreatitis.