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Idiopathic acute pancreatitis: a single-center investigation of clinical and biochemical features

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Abstract

Acute pancreatitis (AP) is termed as idiopathic (IAP) when the underlying conditions of pancreatic inflammation remain unknown. The aim of this study was to identify different clinical features in patients with IAP and AP of known aetiology. All patients hospitalized in our Gastroenterology Unit with an initial diagnosis of AP were recruited. AP was classified as of known aetiology or idiopathic according to clinical examination, serum biochemistry testing, and radiological imaging investigations, and clinical data in both patient groups were compared. A total of 127 patients (80 males, mean age: 57 years) were eligible for the analysis, 92 of which (73%) with AP of known aetiology and 35 (27%) with IAP. The major causes of AP were biliary obstruction (65%) or alcohol abuse (25%). Previous cholecystectomy was more frequent in patients with AP of known aetiology than in patients with IAP (14% versus 0%); patients with IAP showed lower gamma-glutamyl transpeptidase levels, lower daily alcohol intake, and higher frequency of gastroenteritis than patients with AP of known aetiology (34.3% versus 15.2%). Previous intake of nonsteroidal anti-inflammatory drugs was more frequent in patients with IAP than in patients with AP of known aetiology (23% versus 0%). No further differences in clinical features were found between the two patient groups. IAP accounts for almost 20% of cases of AP. An association of AP with gastroenteritis or the use of NSAIDs should be considered if time-related with disease onset, especially in patients with no recurrent attacks.

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Authors and Affiliations

  1. Gastroenterology Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy

    Giovanna Del Vecchio Blanco, Cristina Gesuale, Marzia Varanese, Giovanni Monteleone & Omero Alessandro Paoluzi

  2. Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy

    Diana Giannarelli

  3. Anaesthesiology Unit, Department of Emergency and Critical Care Medicine, University of Rome “Tor Vergata”, Rome, Italy

    Diego Fiume

Authors
  1. Giovanna Del Vecchio Blanco
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  2. Cristina Gesuale
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  3. Diana Giannarelli
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  4. Marzia Varanese
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  5. Diego Fiume
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  6. Giovanni Monteleone
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  7. Omero Alessandro Paoluzi
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Correspondence to Giovanna Del Vecchio Blanco.

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The study protocol conforms with the ethical guidelines of Declaration of Helsinki. This article does not contain any studies with animals performed by any of the authors.

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Del Vecchio Blanco, G., Gesuale, C., Giannarelli, D. et al. Idiopathic acute pancreatitis: a single-center investigation of clinical and biochemical features. Intern Emerg Med 16, 93–99 (2021). https://doi.org/10.1007/s11739-020-02316-0

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  • DOI: https://doi.org/10.1007/s11739-020-02316-0

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