[New aspects of inflammatory pancreatic diseases]

The diagnostic aids of acute pancreatitis include the clinical presentation, laboratory investigations and abdominal sonography. The assessment of amylase creatinin clearance ratio is not superior to simple amylase estimations in identifying unspecific hyperamylasemias apart from acute pancreatitis. The management of acute pancreatitis consists of a standardized basic treatment which does not depend on the degree of the severity of the disease and supplementary measures which are adjusted to the degree of severity and complications. In case of chronic pancreatitis a variety of indirect and direct morphological and functional examinations are available. The diagnostic safety of all procedures--each taken by its own--is below 90%; however, the combined use has to be adjusted to the severity of the symptoms suspicious of pancreatis disease. The therapeutic goal includes the conservative management of the painful recurrences to achieve transmission into the final stage of the disease which presents only minor symptoms. Operation has to be considered in case of untreatable pain and local complications. The obstruction of the pancreatic duct by means of synthetic glue instillations is a hopeful approach.