CHRONIC SCLEROSING PANCREATITIS CAUSING COMPLETE STENOSIS OF THE COMMON BILE DUCT

All surgeons are familiar with acute pancreatitis of the edematous and necrotic types which are associated with relatively fulminating manifestations but associated with only slight or no obstruction of the common bile duct. They are likewise familiar with temporary complete obstruction of the common duct caused by localized chronic pancreatitis involving the head of the pancreas. These lesions are usually localized to the head of the pancreas and are so hard and nodular that it is difficult to differentiate them from carcinoma. Fortunately, this type of local pancreatitis usually subsides within a few months and thus allows restoration of patency of the common duct. In this presentation we wish to call attention particularly to the other type of chronic pancreatitis, namely, that associated with diffuse atrophy and fibrosis throughout the entire gland. Such a process may produce surprisingly little physiologic or mechanical disturbance. However, on other occasions jaundice may develop