Idiopathic Pancreatitis - IPMN

This term describes the type of pancreatitis in which no other obvious cause has been identified (i.e.: gallstones, alcohol, etc) after all appropriate tests have been performed. It is significant, among other reasons, because it can be one way of clinical presentation of some not so common kinds of tumors of the pancreas. Generally, it is rather difficult for an average physician to make this diagnosis because this condition is rare and the level of suspicion is very low. Only doctors with an invested interest in the diseases of the pancreas and a proven track record in this field usually think of this entity and make the appropriate tests to make a definitive diagnosis. What usually happens is that these repeated episodes of mild, or more severe pancreatitis are attributed to other, more common causes, such as gallstones. Because of this, time goes on, the true cause remains unrevealed and the tumor progresses. The kind of tumor we are referring to is the intraductal papillary mucinous neoplasm, or IPMN. This entity was fully recognized relatively recently (about 15 years) and because of this, as well as of the fact that is not very common, it generally goes without a diagnosis for quite a long time. What happens in this disease is that the cells of the pancreas secrete abnormally high volumes of mucous, which accumulates in the main tube of the pancreas (the pancreatic duct) and obstructs the normal flow of pancreatic juice towards the duodenum. This accumulation and impedance of normal flow builds high pressure within the pancreatic duct and causes repeated episodes of pancreatitis. With time, the patient with IPMN not only suffers from pancreatitis, but will develop pancreatic cancer as well. Because of all these reasons, it is of paramount importance for a patient with repeated episodes of pancreatitis, which have no other cause to be attributed to, to be specifically and thoroughly investigated for IPMN. This evaluation and investigation requires someone who is a true expert in pancreatic diseases.