Chronic Pancreatitis and Pancreatic Exocrine Insufficiency: Tigar-O Classification System
Toxic-metabolic Alcoholic Tobacco smoking Hypercalcemia Hyperlipidemia Chronic renal failure Medications—phenacetin abuse Toxins—organotin compounds (e.g., dibutylin dichloride, DBTC) Idiopathic Early onset Late onset Tropical Genetic Cationic trypsinogen (PRSS1) Cystic fibrosis transmembrane conductance regulator gene (CFTR) Calcium-sensing receptor (CASR) Chymotrypsin C gene (CTRC) Pancreatic secretory trypsin inhibitor gene (SPINK1) | Autoimmune Type 1 autoimmune chronic pancreatitis IgG4 systemic Type 2 autoimmune chronic pancreatitis Recurrent and severe acute pancreatitis Postnecrotic (severe acute pancreatitis) Recurrent acute pancreatitis Vascular diseases/ischemia Radiation induced Obstructive Pancreas divisum Duct obstruction (e.g., tumor) Preampullary duodenal wall cysts Posttraumatic pancreatic duct scars |
Abbreviations: DBTC, dibutylin dichloride; TIGAR-O, toxic-metabolic, idiopathic, genetic, autoimmune, recurrent and severe acute pancreatitis, obstructive.