Recurrent Acute Pancreatitis: Clinical Profile and an Approach to Diagnosis

Abstract

Etiological diagnosis was obtained in 67.6% of patients after comprehensive diagnostic work up. Diagnosis in the majority of patients could only be reached after invasive tests (bile crystal analysis, EUS, ERCP). Early diagnosis and etiology-based therapy is the key to optimum patient outcome.

Pancreas divisum as a predisposing factor for chronic and recurrent idiopathic pancreatitis: initial in vivo survey

“…The distribution of the causes of non-tumour induced pancreatitis in the present study grossly coincided with those described in previous reports,12 25 28 although we observed a slightly lower rate of biliary diseases. In comparing groups 1 and 2, the higher rate of pancreatitis in group 2 was natural, while the significantly lower alcohol intake in group 2 was because the patients had been instructed by their doctors not to drink, to avoid worsening their pancreatitis, and possibly because patients with high alcohol intake were excluded as were those with alcohol induced pancreatitis.…”

Recurrent and Relapsing Pancreatitis

“…The problem is compounded because multiple etiologies are present in at least 7% of patients, especially genetic predispositions plus another factor (eg, toxic or obstructive). Establishment of the etiology of acute pancreatitis often requires expensive and sometimes invasive evaluation, some of which entails risk for significant complications, including further pancreatitis [2].…”

Embryological aspects in autoimmune pancreatitis, proposal of autoimmune dorsal pancreatitis

“…In pancreas divisum, the dorsal pancreatic duct becomes the main pancreatic duct and drains most of the pancreas through the minor duodenal papilla. As the minor duodenal papilla is substantially smaller than the major duodenal papilla, and a larger secretory capacity may presumably place a significant load on the minor duodenal papilla, some patients with pancreas divisum display acute pancreatitis [13,14]. The abdominal pain or acute pancreatitis seen in these three patients might have been induced by dorsal pancreatitis of pancreatic divisum.…”