causes of acute pancreatitis

^[1]^[2]^[3]^[4]^[5]

Etiology

common causes (90% of cases)
- alcoholism
- gallstone disease
  - microlithiasis
uncommon causes
- abdominal trauma (especially blunt trauma)
- postoperative state
- ERCP
- infections
  - viral infections: mumps, hepatitis B, coxsackie virus, echovirus, cytomegalovirus, Epstein-Barr virus
  - bacteria: Mycoplasma, Campylobacter, Mycobacterium avium complex (MAI, MAC)
  - parasitic: ascaris, toxoplasmosis
- metabolic
  - hyperlipidemia, hypertriglyceridemia
  - apolipoprotein CII deficiency
  - hypercalcemia
  - renal failure
  - fatty liver of pregnancy
- pharmacologic agents:^[2]^[3]
  - drugs that increase serum triglycerides
  - drugs that cause hypersensitivity
  - drugs with toxic effect
    - valproic acid
    - statins (all statins)
    - sulindac
    - metformin
    - nucleoside reverse transcriptase inhibitors
      - dideoxyinosine (didanosine, ddI)
    - asparaginase
  - drugs that cause pancreatic spasm
    - opiates
    - octreotide
  - others
  - agents probably associated with pancreatitis:
- biliary duct & pancreatic duct abnormalities
- obstruction of the ampulla of Vater
  - regional enteritis
  - duodenal diverticulum
- sphincter of Oddi dysfunction*
- ERCP
- ischemia
  - ischemic hypoperfusion after cardiac surgery
  - atherosclerotic emboli
- vasculitis
- penetrating peptic ulcer
- pancreas divisum*
- cystic fibrosis
- pancreatic cancer
- cholecochocele
- idiopathic
rare
- autoimmune pancreatitis
- viral infection
  - mumps, coxsacke B virus, cytomegalovirus
- parasitic infection
  - toxoplasmosis, ascariasis
- celiac disease

* no convincing data from controlled trials that either pancreatic sphincter of Oddi dysfunction or pancreas divisum plays a role in acute pancreatitis^[5]

Additional terms

acute pancreatitis

References

↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1742
↑ ^2.0 ^2.1 Prescriber's Letter 14(4): 2007 Drug-induced pancreatitis Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230411&pb=PRL (subscription needed) http://www.prescribersletter.com
↑ ^3.0 ^3.1 Prescriber's Letter 16(11): 2009 COMMENTARY: Januvia (Sitagliptin) and Pancreatitis CHART: Drug-Induced Pancreatitis COMMENTARY: Pancreatitis and Byetta (Exenatide) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251025&pb=PRL (subscription needed) http://www.prescribersletter.com
↑ Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
↑ ^5.0 ^5.1 Forsmark CE, Vege SS, Wilcox CM Acute Pancreatitis N Engl J Med 2016; 375:1972-1981 November 17, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27959604 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1505202

[ref1-1] Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1742

[ref2-2] 2.0 ^2.1 Prescriber's Letter 14(4): 2007 Drug-induced pancreatitis Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230411&pb=PRL (subscription needed) http://www.prescribersletter.com

[ref3-3] 3.0 ^3.1 Prescriber's Letter 16(11): 2009 COMMENTARY: Januvia (Sitagliptin) and Pancreatitis CHART: Drug-Induced Pancreatitis COMMENTARY: Pancreatitis and Byetta (Exenatide) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251025&pb=PRL (subscription needed) http://www.prescribersletter.com

[ref4-4] Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015

[ref5-5] 5.0 ^5.1 Forsmark CE, Vege SS, Wilcox CM Acute Pancreatitis N Engl J Med 2016; 375:1972-1981 November 17, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27959604 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1505202

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[2]

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causes of acute pancreatitis

Etiology

Additional terms

References

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