Etiology

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Epidemiological studies performed using similar admission criteria and over different time periods are limited to a few geographical areas. All indicate that the incidence of acute pancreatitis is increasing. Biliary stones and alcohol abuse account for 70 per cent of cases; gallstone impaction is more common in females, and chronic alcoholism is more common in males. A minority (5-10 per cent) are caused by various other conditions ( Ta.b.le.1). Acute idiopathic pancreatitis occurs in 20 to 40 per cent, although biliary sludge can be demonstrated in approximately two-thirds of these. A causal association has been made between biliary sludge and acute pancreatitis.

Table 1 Etiological factors in acute pancreatitis

Most etiological factors have a significant impact on investigation, prognosis, and therapeutic approach. Recurrent attacks should trigger appropriate investigation for biliary sludge or very small stones, hypertriglyceridemia, drug-induced pancreatitis, and occult abnormalities in the biliary and/or pancreatic duct.

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