De la pancréatite chronique aux pancréatites chroniques From the chronic pancreatitis to chronic pancreatites

Résumé Alors que l’alcoolisme chronique est responsable de 60 à 90 % des pancréatites chroniques, des causes nouvelles sont aujourd’hui mieux connues. Les pancréatites génétiques peuvent être liées aux mutations du gène du trypsinogène cationique PRSS1 (100 familles en France), de son inhibiteur SPINK1 ou du gène CFTR de la mucoviscidose. La pancréatite autoimmune, souvent intégrée dans une maladie systémique à IgG4 pouvant atteindre les voies biliaires, les glandes salivaires, le rétropéritoine et/ou les reins, a des critères diagnostiques bien précis (critères HISORt de la Mayo Clinic), avec en imagerie des anomalies canalaires et parenchymateuses parfois pseudotumorales. C’est une maladie corticosensible, mais les rechutes sont fréquentes et l’évolution à long terme est encore mal précisée. © 2009 Publié par Elsevier Masson SAS.

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