Pancreatic Calcification - to Anyse and anyone else interested

[Guest guest]

Hi Anyse,

I am planning on delving deeper into this subject but I thought I

would give you a quick answer on what I have learned from

skimming some articles. I didn't want you to think I was forgetting

about your questions.

Basically what I have found is that there are two types of

calcifications that are described with CP.

The first type are intra-ductal calcifications or " stones " . One

theory is that when the juices get too viscous (also due to low

bicarb production), that they form proteinaceous plugs. These

plugs can then act as the stimulas (nadis) for calcifications

(kinda like seeding a cloud). It is thought that anything that

makes the juice more viscous can be the initiator for these

events. One factor that may do this is drinking alcohol. Another

cause of high viscosity can be the hereditary CP that is linked to

the CF gene. My understanding is that this may take some time

to occur...it is not a quick thing to actually form the stones. One

way to detect these is by plain x-ray, by CT, MRCP, ERCP, EUS

etc...anything that will actually see the stones in the duct. Or they

look for " filling " defects by ERCP or dilatation that may indicate

stones in the duct. My understanding is that treating this is

relatively easy (as compared to the other kind of pancreatic

calcification). That is, they can retrieve the stones by ERCP or

they can use lithotripsy.

The other type of calcification is a diffuse parenchymal kind. This

is the calcification that is associated with fibrosis of the organ as

it gets damaged by the disease process. This is harder to

detect by plain x-ray and ERCP. I think that CT and EUS have a

better chance of seeing these (anything that looks at the whole

organ not just the ducts). I think that treating this type of

calcifiacation is relatively difficult and usually surgery, if indicated,

is the only way to get rid of them. My understanding is that these

are usually seen in advanced cases of CP. Fibrosis is the whole

thing of cell death which initiates a wide range of inflammatory

responses that can ultimately lead to clacification - A common

end point for lots of disease processes - from hardening of the

arteries to joint destruction to alzheimers (I think).

So it seems to me that the type of calcification can indicate a

possible mechanism / etiology of the disease and can

determine the therapy (in a very loose sense).

I hope this helps somewhat....please let me know what specific

questions you have that this information causes you to have.

I am feeling better than Friday....but I notice that I am somewhat

dizzy and fuzzy in my thinking so I am not as able to grasp or

convey information very well yet. I am not sure why I am this

way...increased in meds? the process of whatever is going on

with me? so forgive me if things are not making much sense or

if I am not able to respond in a timely manner.

Laurie