Pancreatitis in the Elderly

  • Peter D. Zdankiewicz
  • Dana K. Andersen


The anatomy of the pancreas changes with normal aging. Atrophy of the pancreas occurs with age, and its weight may fall from a normal 60–100 g to 40 g or less by 85 years of age.1 This may actually facilitate detection of a small or subtle pancreatic mass, which may appear more prominent on imaging studies relative to the atrophied gland. The head of the pancreas and duodenal C loop may be displaced interiorly, with the ampulla of Vater found as low as the third or fourth lumbar vertebra; and in one case it was reported at the level of the second sacral vertebra.2 This inferior displacement of the pancreas can potentially cause difficulty interpreting radiographic studies.


Acute Pancreatitis Chronic Pancreatitis Biliary Tract Disease Gallstone Pancreatitis Biliary Pancreatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lillemoe KD. Pancreatic disease in the elderly patient. Surg Clin North Am 1994;74:317–344.PubMedGoogle Scholar
  2. 2.
    Kreel L, Sandin B. Changes in pancreatic morphology associated with aging. Gut 1973;14:962–970.PubMedCrossRefGoogle Scholar
  3. 3.
    Milbourne E. Caliber and appearance of the pancreatic ducts and relevant clinical problems. Acta Chir Scand 1960;118:286–303.Google Scholar
  4. 4.
    Sandin B, Kreel L, Slavin G. The pancreas: radiographic demonstration of pancreatic morphology at autopsy. Radiography 1973;39:151–157.PubMedGoogle Scholar
  5. 5.
    Schmitz-Moormann P, Himmelmann GW, Brandes J-W, et al. Comparative radiological and morphological study of human pancreas: pancreatitis-like changes in postmortem ductograms and their morphological pattern; possible implication for ERCP. Gut 1985;26:406–414.PubMedCrossRefGoogle Scholar
  6. 6.
    Rosenberg IR, Friedland N, et al. The effect of age and sex upon human pancreatic secretion of fluid and bicarbonate. Gastroenterology 1966;50:191–194.Google Scholar
  7. 7.
    Bartos V, Groh J. The effect of repeated stimulation of the pancreas on the pancreatic secretion in young and aged men. Gerontol Clin 1969;11:56–62.CrossRefGoogle Scholar
  8. 8.
    Elahi D, Andersen DK, Muller DC, Tobin JD, Brown JC, Andres R. The enteric enhancement of glucose-stimulated insulin release: the role of GIP in aging, obesity, and non-insulin dependent diabetes mellitus. Diabetes 1984;33: 950–957.PubMedCrossRefGoogle Scholar
  9. 9.
    Chen M, Bergman RN, Pacini G, Porte D Jr, et al. Pathogenesis of age-related glucose intolerance in man: insulin resistance and decreased β-cell function. J Clin Endocrinol Metab 1985;60:13–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Goldberg AP, Andres R, Bierman EL. Diabetes mellitus in the elderly. In: Hazzard WR, Andres R, Bierman EL, Blass JP (eds) Principles of Geriatric Medicine and Gerontology, 2nd ed. New York: McGraw-Hill, 1990:739–758.Google Scholar
  11. 11.
    Park J, Fromkes J, Cooperman M, et al. Acute pancreatitis in the elderly: pathogenesis and outcome. Am J Surg 1986;152:638–642.PubMedCrossRefGoogle Scholar
  12. 12.
    Steinberg WM. Acute pancreatitis: never leave a stone unturned. N Engl J Med 1992;326:635.PubMedCrossRefGoogle Scholar
  13. 13.
    Browder W, Patterson MD, Thompson JL, Walters DN. Acute pancreatitis of unknown etiology in the elderly. Ann Surg 1993;217:469–175.PubMedCrossRefGoogle Scholar
  14. 14.
    Fan ST, Choi TK, Lai CS, Wong J. Influence of age on the mortality from acute pancreatitis. Br J Surg 1988;75:463–166.PubMedCrossRefGoogle Scholar
  15. 15.
    Banks PA. Pancreatic disease in the elderly. Semin Gastrointest Dis 1994;5:189–196.PubMedGoogle Scholar
  16. 16.
    Lankisch PG. Undetected fatal acute pancreatitis: why is the disease so frequently overlooked? Am J Gastroenterol 1991;86:322–326.PubMedGoogle Scholar
  17. 17.
    Ros E, Navarro S, Bru C, et al. Occult microlithiasis in “idiopathic” acute pancreatitis: prevention of relapses by cholecystectomy or ursodeoxycholic acid therapy. Gastroenterology 1991;101:1701–1709.PubMedGoogle Scholar
  18. 18.
    Lee SP, Nicholls JF, Park HZ. Biliary sludge as a cause of acute pancreatitis. N Engl J Med 1992;326:589–593.PubMedCrossRefGoogle Scholar
  19. 19.
    Williamson RCN. Endoscopic sphincterotomy in the early treatment of acute pancreatitis. N Engl J Med 1993;328:279–280.PubMedCrossRefGoogle Scholar
  20. 20.
    Hanks JB, Curtis SE, Hanks BB, Andersen DK, Cox JL, Jones RS. Gastrointestinal complications after cardiopulmonary bypass. Surgery 1982;92:394–400.PubMedGoogle Scholar
  21. 21.
    Banks PA. Predictors of severity in acute pancreatitis. Pancreas 1991;6(suppl 1):s7-sl2.CrossRefGoogle Scholar
  22. 22.
    Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med 1994;330:1198–1207.PubMedCrossRefGoogle Scholar
  23. 23.
    Gambill EE. Pancreatitis associated with pancreatic carcinoma: a study of 26 cases. Mayo Clin Proc 1971;46:174–177.PubMedGoogle Scholar
  24. 24.
    Itai Y, Moss AA, Goldberg HI. Pancreatic cysts caused by carcinoma of the pancreas: a pitfall in the diagnosis of pancreatic carcinoma. J Comput Assist Tomogr 1982;6:772–776.PubMedCrossRefGoogle Scholar
  25. 25.
    Gullo L, Sipahi HM, Pezzilli R. Pancreatitis in the elderly. J Clin Gastroenterol 1994;19:64–68.PubMedCrossRefGoogle Scholar
  26. 26.
    Ranson JHC, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974;139:69–81.PubMedGoogle Scholar
  27. 27.
    Fan ST, Lai ECS, Mok FP, Lo CM, Zheng SS, Wong J. Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med 1993;328:228–232.PubMedCrossRefGoogle Scholar
  28. 28.
    Büchler M, Uhl W, Beger HG. Surgical strategies in acute pancreatitis. Hepatogastroenterology 1993;40:563–568.PubMedGoogle Scholar
  29. 29.
    Magnuson TH, Ratner LE, Zenilman ME, Bender JS. Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 1997;63:91–96.PubMedGoogle Scholar
  30. 30.
    De Angelis C, Valente G, Spaccapietra M, et al. Histological study of alcoholic, nonalcoholic, and obstructive chronic pancreatitis. Pancreas 1992;7:193–196.PubMedCrossRefGoogle Scholar
  31. 31.
    Nagai H, Ohtsuto K. Pancreatic lithiasis in the aged: its clin-icopathology and pathogenesis. Gastroenterology 1984;86: 331–338.PubMedGoogle Scholar
  32. 32.
    Ammann RW. Chronic pancreatitis in the elderly. Gastroenterol Clin North Am 1990;19:905–914.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Peter D. Zdankiewicz
  • Dana K. Andersen

There are no affiliations available

Personalised recommendations