Diagnosis made when 3 of the following 4 is present
Parenchymal calcifications
Intraductal calcifications
Parenchymal atrophy
Cystic lesions
Focal pancreatitis and malignancy in chronic pancreatitis are hard to distinguish on imaging. One sign described is the ‘duct penetrating sign’. The main duct traversing inflammation shows a patent lumen, but a malignant fibrotic lesion with obstruct it. Secreting enhanced MRCP opens up inflammatory mass ducts, while cancer mass ducts remain stenosed
Vascular complications are more common in longstanding chronic pancreatitis