The pathology of chronic pancreatic disease in Uganda

Abstract

Chronic pancreatic disease may be defined pathologically as a condition characterized by loss of pancreatic lobular architecture with replacement of most of the parenchyma by fibrous tissue. These features are accompanied by variable degrees of acinar atrophy and duct dilatation. Intraduct calculi are frequently but not invariably present. This entity must be distinguished from simple fibrosis of the pancreas which may be mild or moderate but does not lead to architectural disorganization. From a general survey of the literature it is apparent that this distinction has not been made by many authors and therefore it is difficult to estimate the frequency of the disease in any one area. However, there is evidence to show that the disease is common in the United States of America, parts of West Europe, South Africa and Australia. In these countries the disease is frequently associated with chronic alcoholism. In comparative study of Autopsy materials in Glasgow and Kampala I find that chronic pancreatic disease is uncommon in Glasgow where acute haemorrhagic pancreatitis is common. In Kampala where “silent” acute interstitial pancreatitis is seen chronic pancreatic disease is common.