Is it possible to have chronic pancreatitis without having had acute pancreatitis? could acute pancreatitis be missed due to not being severe enough to land person in a hospital? year of upper left abd & back pain. mrcp, colonoscopy &endoscopy clear?

The diagnosis of chronic pancreatitis is difficult & sometimes the cause is elusive. Gall stones are high on the list of causes of acute pancreatitis. Have you had a prior history of gall bladder disease? Chronic pancreatitis often leads to intestinal malabsorption of fats or diabetes. Some cases are caused by an autoimmune disorder. Acute episode could have been missed. GI MD advises best.

Usually chronic pancreatitis follows acute but it really depends on the cause. Alcohol is the most common cause of Chronic Pancreatitis and can occur without a distinct episode of acute pancreatitis by over use of alcohol. Gallstones more rarely can have the same impact if the patient has chronic cholecystitis/cholelithiasis over long periods of time. Hereditary pancreatitis too can do it.