**4.2 Pathology**

Parenchymal fibrosis, with loss of acinar cells, results in exocrine pancreatic insufficiency (EPI) as a late stage of the disease and needs to be treated with pancreatic enzyme replacement therapies. Then normal acini are replaced by fibroblasts and lymphocytic infiltration. Furthermore, progressively endocrine cells are damaged too resulting in diabetes mellitus (DM) that often occurs post chronic pancreatitis [23].
