Acute Pancreatitis: The Latest on Etiology

Albert B. Lowenfels, MD

Disclosures

December 02, 2015

In This Article

Introduction

At the 46th annual meeting of the American Pancreatic Association, more than 500 researchers spent 4 days discussing the etiology, diagnosis, and treatment of the major diseases of the pancreas. This report summarizes several sessions concerning acute pancreatitis and focuses on potentially modifiable risk factors. Drug-induced pancreatitis, a recognized entity caused by exposure to many different types of drugs, was not discussed at this meeting.

Acute Pancreatitis

The incidence of acute pancreatitis is 40-60 new cases per 100,000 per year—making pancreatitis the most common cause for hospitalization of patients with a gastrointestinal disorder. This statistic, based upon administrative hospital discharge data, may be an overestimate because in some patients the diagnosis was established only by the admission criteria of an elevated serum amylase and might not satisfy more rigorous criteria necessary for establishing the diagnosis of acute pancreatitis. The incidence of acute pancreatitis varies by locality because of the variation in the frequency of major risk factors for pancreatitis.

Has the frequency of pancreatitis changed over time? In data collected from a population-based general practice database in the United Kingdom over the past 2 decades, the frequency of acute pancreatitis has almost doubled.[1] This dramatic increase was observed in both males and females. The increase is likely to be related to increasing rates of obesity, which is strongly related to gallstones, and to increasing amounts of alcohol consumption. The finding of an increase in pancreatitis has also been noted in other reports based on hospital discharge data.

Sex and race are related to the frequency of pancreatitis. Although the overall incidence of acute pancreatitis is similar in males and females, gallstone pancreatitis is more frequent in females, whereas acute alcoholic pancreatitis is more frequent in males. Race is also an important factor: For reasons that are currently unknown, acute pancreatitis is about three times more frequent in black patients than in white patients.[2]

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