Advertisement

“Idiopathic” Pancreatitis: Do We Need to Know the Cause?

  • C. D. Johnson

Abstract

In the United Kingdom about half the attacks of acute pancreatitis are related to gallstones and about one-quarter to alcohol consumption (Table 1). Other aetiological agents have been reviewed elsewhere (Tables 2 and 3). This chapter is concerned with the search for an aetiology in patients in whom initial assessment has shown no evidence of gallstones and no excessive alcohol consumption (non-gallstone non-alcohol related (NGNA) pancreatitis). Patients with recurrent NGNA pancreatitis deserve particularly thorough investigation to forestall further sttacks, although these patients have a similar distribution of aetiology to primary cases (Table 4).

Keywords

Acute Pancreatitis Common Bile Duct Stone Endoscopic Sphincterotomy Pancreas Divisum Ampullary Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Acosta JM, Ledesma CL (1974) Gallstone migration as a cause of acute pancreatitis. N Engl J Med 290: 484–487PubMedCrossRefGoogle Scholar
  2. Clemens JA, Cameron JL (1989) The pathogenesis of acute pancreatitis. In: Carter DC, Warshaw AL (eds) Pancreatitis. Churchill Livingstone, Edinburgh, pp 1–30Google Scholar
  3. Cooperman M, Ferrara JJ, Carey LC, Thomas FB, Martin EW, Fromkes J J (1981) Idiopathic acute pancreatitis: the value of endoscopic retrograde cholangiopancreatography. Surgery 90: 666–670PubMedGoogle Scholar
  4. Corfield AP, Cooper MJ, Williamson RCN et al. (1985a) Prediction of severity in acute pancreatitis: prospective comparison of three prognostic indices. Lancet ii: 403–407CrossRefGoogle Scholar
  5. Corfield AP, Cooper MJ, Williams RCN (1985b) Acute pancreatitis: a lethal disease of increasing incidence. Gut 26: 724–729PubMedCrossRefGoogle Scholar
  6. Dickson AP, O’Neill J, Imrie CW (1984) Hyperlipidaemia, alcohol abuse and acute pancreatitis. Br J Surg 71: 685–688PubMedCrossRefGoogle Scholar
  7. Farinon AM, Ricci CL, Sianesi M, Percudani M, Zanella E (1987) Physiopathologic role of microlithiasis in gallstone pancreatitis. Surg Gynecol Obstet 164: 252–256PubMedGoogle Scholar
  8. Feller ER (1984) Endoscopic retrograde cholangiopancreatography in the diagnosis of unexplained pancreatitis. Arch Intern Med 144: 1797–1799PubMedCrossRefGoogle Scholar
  9. Goodman AJ, Neoptolemos JP, Carr-Locke DL, Finaly DBL, Fossard DP (1985) Detection of gallstones after acute pancreatitis. Gut 26: 125–132PubMedCrossRefGoogle Scholar
  10. Guzman S, Nervi F, Llanos O, Leon P, Valdivieso V (1985) Impaired lipid clearance in patients with previous acute pancreatitis. Gut 26: 888–891PubMedCrossRefGoogle Scholar
  11. Heath D, Leese T, Carr-Locke DL, Thornton Holmes J (1987) Obstructing calculous material in a periampullary duodenal diverticulum associated with primary common bile duct calculi and acute pancreatitis. Br J Surg 74: 648PubMedCrossRefGoogle Scholar
  12. Imrie CW, Ferguson JC, Sommerville RG (1977) Coxsackie and mumps virus infection in a prospective study of acute pancreatitis. Gut 18: 53–56PubMedCrossRefGoogle Scholar
  13. Kelly TJ (1976) Gallstone pancreatitis: pathophysiology. Surgery 80: 488–492PubMedGoogle Scholar
  14. London NJM, Neoptolemos JP, Lavelle J, Bailey I, James D (1989) Serial computed tomography scanning in acute pancreatitis: a prospective study. Gut 30: 397–403PubMedCrossRefGoogle Scholar
  15. Neoptolemos JP, Carr-Locke DL, London N, Bailey I, Fossard DP (1988a) ERCP findings and the role of endoscopic sphincterotomy in acute gallstone pancreatitis. Br J Surg 75: 954–960PubMedCrossRefGoogle Scholar
  16. Neoptolemos JP, Davidson BR, Winder AF, Vallance D (1988b) Role of duodenal bile crystal analysis in the investigation of “idiopathic” pancreatitis. Br J Surg 75: 450–453PubMedCrossRefGoogle Scholar
  17. Ranson HC (1984) Acute pancreatitis: pathogenesis, outcome and treatment. Clin Gastroenterol 13: 843–863PubMedGoogle Scholar
  18. Robertson JFR, Imrie CW (1987) Acute pancreatitis associated with carcinoma of the ampulla. Br J Surg 74: 395–397PubMedCrossRefGoogle Scholar
  19. Sitges–Serra A, Alonso M, de Lecea C, Gores PF, Sutherland DER (1988) Pancreatitis and hyperparathyroidism. Br J Surg 75: 158–160CrossRefGoogle Scholar
  20. Thomson SR, Hendry WS, McFarlane GA, Davidson AI (1987) Epidemiology and outcome of acute pancreatitis. Br J Surg 74: 398–401PubMedCrossRefGoogle Scholar
  21. Toouli J, Roberts-Thomson IC, Deut J, Lee J (1985) Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 72: 859–863PubMedCrossRefGoogle Scholar
  22. Waldron R, Drumm J, McCarthy CF, Murray JP, Murphy B (1985) Surgically correctable recurring pancreatitis. Br J Surg 72: 203PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1991

Authors and Affiliations

  • C. D. Johnson

There are no affiliations available

Personalised recommendations