Most common causes
The U.S. Food and Drug Administration (FDA) reported in August 2008 six cases of hemorrhagic or necrotizing pancreatitis in patients taking Byetta, a diabetes medicine approved in 2005. Two patients died. The FDA previously reported 30 other cases of pancreatitis. Patients taking Byetta should promptly seek medical care if they experience unexplained severe abdominal pain with or without nausea and vomiting.
A common mnemonic for the causes of pancreatitis spells "I get smashed", an allusion to heavy drinking (one of the many causes):
- I - idiopathic. Thought to be hypertensive sphincter or microlithiasis.
- G - gallstone. Gallstones that travel down the common bile duct and which subsequently get stuck in the Ampulla of Vater can cause obstruction in the outflow of pancreatic juices from the pancreas into the duodenum. The backflow of these digestive juices causes lysis (dissolving) of pancreatic cells and subsequent pancreatitis.
- E - ethanol (alcohol)
- T - trauma
- S - steroids
- M - mumps (paramyxovirus) and other viruses (Epstein-Barr virus, Cytomegalovirus)
- A - autoimmune disease (Polyarteritis nodosa, Systemic lupus erythematosus)
- S - scorpion sting (e.g. ''Tityus trinitatis''), and also snake bites
- H - hypercalcemia, hyperlipidemia/hypertriglyceridemia and hypothermia
- E - ERCP (Endoscopic Retrograde Cholangio-Pancreatography - a procedure that combines endoscopy and fluoroscopy)
- D - drugs (SAND - steroids & sulfonamides, azathioprine, NSAIDS, diuretics such as furosemide and thiazides, & didanosine) and duodenal ulcers
This mnemonic is also arranged according to the frequency of its causes. Thus: Gallstone pancreatitis is more common than pancreatitis caused by trauma, alcohol, or steroids.
Less common causes
- pancreas divisum
- long common duct
- carcinoma of the head of pancreas, and other cancer
- ascaris blocking pancreatic outflow
- chinese liver fluke
- ischemia from bypass surgery
- fatty necrosis
- pregnancy
- infections other than mumps, including varicella zoster
- repeated marathon running.
- cystic fibrosis
- valproic acid
- Anorexia or bulimia
Causes by demographic
The most common causes of pancreatitis, are as follows :
- Western countries - chronic alcoholism and gallstones accounting for more than 85% of all cases
- Eastern countries - gallstones
- Children - trauma
- Adolescents and young adults - mumps
Further Reading
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"Acute pancreatitis"
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