Morphology of Nerves in Chronic Pancreatitis and the Interrelationship with Inflammatory Tissue

  • D. E. Bookman
  • M. Büchler
  • P. Malfertheiner
  • H. G. Beger
Conference paper


Chronic pancreatitis causes profound changes to occur in the makeup of the pancreas. There is functional and morphological regression of the exocrine parenchyma. Acinar cells in affected areas contain fewer or no zymogen granules; the cells decrease in height. The result of this reversion is tubular complexes, which are derived from a combination of acini and small ducts, but which have the appearance of a collection of ducts [5]. These areas are sometimes interpreted as resulting from ductular proliferation, but there is a notable paucity of mitoses. The acinar tissue disappears with time. Some of the loss comes about by a process which has been termed apoptosis because the apical part of the acinar cell is sloughed off. Some of the cells simply disintegrate and become part of the amorphous material which may be drained away by patent ducts or retained in the connective tissue space.


Chronic Pancreatitis Acinar Cell Enteric Nervous System Zymogen Granule Sympathetic Fiber 
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  1. 1.
    Alvarado F (1955) Distribution of nerves within the pancreas. J Int Coll Surg 23:675–699PubMedGoogle Scholar
  2. 2.
    Beger HG, Krautzberger W, Bittner R, Büchler M, Limmer J (1985) Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery 97:467–473PubMedGoogle Scholar
  3. 3.
    Bockman DE (1987) Gut-associated macrophages. In: Brostoff J, Challacombe SJ (eds) Food allergy and intolerance. Baillière Tindall, London, pp 67–87Google Scholar
  4. 4.
    Bockman DE (1988) Systems underlying involvement of the duodenum in pancreatic disease. Pancreas 3:592Google Scholar
  5. 5.
    Bockman DE, Boydston WR, Anderson MC (1982) Origin of tubular complexes in human chronic pancreatitis. Am J Surg 144:243–249PubMedCrossRefGoogle Scholar
  6. 6.
    Bockman DE, Büchler M, Malfertheiner P, Beger HG (1988) Analysis of nerves in chronic pancreatitis. Gastroenterology 94:1459–1469PubMedGoogle Scholar
  7. 7.
    Durack DT, Ackerman SJ, Loegering DA, Gleich GJ (1981) Purification of human eosinophil-derived neurotoxin. Proc Natl Acad Sci USA 78:5165–5169PubMedCrossRefGoogle Scholar
  8. 8.
    Frey CF (1973) Ninety-five percent pancreatectomy. In: Carey LC (ed) The pancreas. Mosby, St Louis, pp 202–229Google Scholar
  9. 9.
    Keith RG, Keshavjee SH, Kerenyi NR (1982) Neuropathology of chronic pancreatitis in humans. Can J Surg 28:207–211Google Scholar
  10. 10.
    Kirchgessner AL, Gershon MD (1989) Innervation of the rat’s pancreas: analysis of direct projections from neurons in myenteric ganglia of the duodenum and stomach and intrapancreatic ganglia. Gastroenterology 96:A258Google Scholar
  11. 11.
    Odaira C, Koizumi M, Sawai T (1987) Quantitative study on tissue mast cells in pancreatic disease. Digestion 38:50Google Scholar
  12. 12.
    Richins CA (1945) The innervation of the pancreas. J Comp Neurol 83:223–236PubMedCrossRefGoogle Scholar
  13. 13.
    Tiscornia OM (1977) The neural control of exocrine and endocrine pancreas. Am J Gastroenterol 67:541–560PubMedGoogle Scholar
  14. 14.
    White TT (1982) Pain. In: Bradley EL III (ed) Complications of pancreatitis. Saunders, Philadelphia, pp 203–222Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • D. E. Bookman
  • M. Büchler
  • P. Malfertheiner
  • H. G. Beger
    • 1
    • 2
  1. 1.Department of AnatomyMedical College of GeorgiaAugustaUSA
  2. 2.Departments of Surgery and Internal MedicineUniversity of UlmGermany

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