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Pancreatitis, Pancreatic Lithiasis, and Diabetes Mellitus

  • Chapter
The Diabetic Pancreas

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Abstract

In a 1962 review of this topic by Lazarus and Volk1 pancreatitis and pancreatic lithiasis in their relation to diabetes mellitus were dealt with in separate chapters. Since then, however, it has become evident that stone formation in the pancreas is nearly always a late phase in the course of chronic or chronic recurrent pancreatitis. Also, while in the past, occasional authors2 distinguished between intraductal and parenchymal pancreatic lithiasis, and while it may still be difficult to determine by radiologic means whether the stones lie within the ducts or without,3–4 virtually all recent observers emphasize the exclusively intraductal location of pancreatic calculi.5–16 Seemingly diffiise parenchymal calcifications merely reflect the presence of small amorphous calculi in the finer radicles of the pancreatic ducts; and while the epithelium that lines the radicles may perish due to stasis, pressure necrosis, and infection, careful histologic study will often succeed in demonstrating the presence of remnants of the ductular epithelium immediately adjacent to the concrements.8,14 It is true that calcium deposits may also occur during and after the saponification of necrotic foci of pancreatic fat; however, these soaps, once formed, are absorbed and are not converted to inorganic calcium salts.7 In summarizing these observations. Sarles et al.10 concluded that to differentiate between (ductal) lithiasis and (parenchymal) calcifying pancreatopathy no longer appears justified.

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Authors and Affiliations

  1. Department of Pathology, University of California Irvine Medical Center, 92668, Orange, California, USA

    Bruno W. Volk

  2. Department of Pathology, State University of New York, Downstate Medical Center, Brooklyn, New York, USA

    Klaus F. Wellmann

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  1. Bruno W. Volk
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Editors and Affiliations

  1. University of California Irvine Medical Center, Orange, California, USA

    Bruno W. Volk M.D.  & Edward R. Arquilla M.D., Ph.D.  & 

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Volk, B.W., Wellmann, K.F. (1985). Pancreatitis, Pancreatic Lithiasis, and Diabetes Mellitus. In: Volk, B.W., Arquilla, E.R. (eds) The Diabetic Pancreas. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-0348-1_13

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