Acute Pancreatitis beyond Gallstones and Alcohol

Acute pancreatitis (AP) is a potentially grave abdominal condition where the pancreas gets inflamed and is associated with variable regional and systemic involvement. The inflammatory state is usually characterized by acute abdominal pain with concomitant increase in serum pancreatic enzymes. Investigative workup includes serum amylase, lipase, liver function tests, triglycerides, serum calcium, and parathyroid hormone (PTH) assay; imaging includes ultrasonography, computed tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), and/or endoscopic ultrasound in some patients.

To identify the etiology and frequency of nonalcoholic and nonbiliary causes of AP in a hospital scenario, and analyze the severity and outcome of the disease.

A prospective, observational, hospital-based study was conducted on 150 consecutive AP patients in the Department of Gastroenterology at Yashoda Hospitals, Secunderabad, India. A total of 150 consenting patients who were hospitalized consecutively with AP were included, and subjects with chronic pancreatitis were excluded.

Overall, 150 patients were included; 117 (72.9%) were men, and 37 (27.1%) women. Alcohol was the most common etiological factor noted in 54 (36%), followed by biliary tract disease 45 (30%), idiopathic 21 (14%), hypertriglyceridemia 7 (4.67%), endoscopic retrograde cholangiopancreatography (ERCP)-related 3 (2%), infection-related 5 (3%), hyperparathyroidism 3 (2%), and drug-induced 8 (5.33%). The most common presentation was abdominal pain (98.6%). Organ failure and mortality were low in the nonalcoholic/nonbiliary cause of pancreatitis.

AP in our study reports a significant number of nonalcoholic/nonbiliary causes. The current study showed that the mortality rate in nonalcoholic/nonbiliary cases was low. Despite low mortality in this group, there is a need to identify these causes and treat on an urgent basis for limiting the hospital stay.