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In addition to pain, which is the most common presenting symptoms in chronic pancreatitis (CP), there are several complications that may occur, including:

• Diabetes - results from endocrine insufficiency or impaired production of insulin and develops in approximately 33%-50% of patients with chronic pancreatitis.
• Nutrient malabsorption - results from exocrine insufficiency or impaired production of pancreatic digestive enzymes. If pancreatic enzyme secretions are reduced more than 90%, absorption of nutrients is affected and can lead to weight loss and steatorrhea. People with chronic pancreatitis may also experience deficiency of Vitamins A, D, E, K, and/or B12.
• Pseudocyst - a fluid collection contained within a well-defined capsule. Pseudocysts may develop with acute or chronic pancreatitis. If the pseudocyst is not symptomatic, it may resolve spontaneously. However, if it is symptomatic and is connected to the pancreatic ductal system, it usually will not resolve without surgical intervention (e.g., drainage). It is the most common complication, occurring in up to 30% of patients, especially those with alcoholic pancreatitis. Complications due to pseudocysts include: infection, rupture, obstruction of ducts, or intracystic bleeding.
• Calcifications - small deposits of mineral salts that collect in the pancreas and can lead to destruction and hardening of the tissue. Calcifications can develop up to 8-10 years after the first attack of pancreatitis and if necessary are removed surgically.
• Pancreatic duct dilatation or stricture
• Obstruction of bile ducts - up to 9% of patients with CP develop bile duct involvement as it passes through the head of the pancreas. The duct may develop strictures or may be compressed due to inflammation. Also, if pancreatic tissue becomes hard and fibrous, it can lead to stenosis or obstruction of the biliary ducts.
• Duodenal stenosis - narrowing of the duodenum
• Portal hypertension - Increased pressure in the portal vein that carries blood into the liver
• Sphincter of Oddi Dysfunction (SOD) - The sphincter of Oddi is a muscle that surrounds the ducts and is located at the point where the bile and pancreatic ducts enter the duodenum. Its purpose is to allow drainage of the contents in the ducts. Dysfunction of the valve prevents adequate drainage and causes pressure to build up in these two ducts which can lead to recurrent episodes of pancreatitis. Although not a common complication, it can be related to acute as well as chronic pancreatitis.
• Ascites - a collection of fluid in the peritoneal cavity which can occur if a cyst ruptures.
• Pancreatic fistula - an opening in the pancreatic tissue that may result in pancreatic fluid entering the area outside of the pancreas. Most close spontaneously but some may require endoscopic or surgical intervention.
• Blood clots in the splenic vein - this is a very rare complication.
• Sepsis
• Pancreatic abscess
• Pancreatic cancer