Case Control Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2016; 22(6): 2104-2110
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2104
Prospective evaluation of the cause of acute pancreatitis, with special attention to medicines
Mitra Rashidi, Ola Røkke
Mitra Rashidi, Department of Plastic and Reconstructive Surgery, Rikshospitalet, Oslo University Hospital, Nydalen 0372, Oslo, Norway
Ola Røkke, Department of Gastroenterological Surgery, Akershus University Hospital, Akershus 1478, Norway
Ola Røkke, Medical Faculty, University of Oslo, Nydalen 0316, Oslo, Norway
Author contributions: Rashidi M and Røkke O designed the study, collected the data, conducted the statistical analysis and wrote the manuscript.
Institutional review board statement: The local ethics committee was contacted and permission was not required as no intervention outside the normal hospital protocol was planned.
Conflict-of-interest statement: The authors of this manuscript declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitra Rashidi, MD, Department of Plastic and Reconstructive Surgery, Rikshospitalet, Oslo University Hospital, Nydalen 0372, Oslo, Norway. mitrarashidi@hotmail.com
Telephone: +47-23-070000 Fax: +47-23-076070
Received: June 17, 2015
Peer-review started: June 19, 2015
First decision: July 10, 2015
Revised: July 24, 2015
Accepted: September 13, 2015
Article in press: September 14, 2015
Published online: February 14, 2016
Abstract

AIM: To investigate the cause of acute pancreatitis (AP) by conducting a thorough investigation of drugs and their possible etiological role.

METHODS: We investigated the cause of AP in a large retrospective cohort of 613 adult patients admitted with AP at the Akershus University Hospital, Norway, from 2000 until 2009, who were evaluated with standard ward investigations. This group was compared with a prospectively evaluated group (n = 57) admitted from January 2010 until September 2010 who investigated more extensively using medical history and radiological assessment.

RESULTS: The groups were comparable with regards to gender, age, comorbidity and severity. The most common etiology was bile stones and alcohol, occurring in 60% in both groups. The prospective group was examined more thoroughly with regards to the use of alcohol and medicines. An increased number of radiological investigations during hospital stay and at follow-up were also performed. A more extensive use of radiological evaluation did not increase the detection frequency of bile stones. In the prospective group, more than half of the patients had two or more possible causes of pancreatitis, being mostly a combination of bile stones and drugs. No possible cause was found in only 3.5% of these patients, compared with 29.7% in the retrospective group.

CONCLUSION: A detailed medical history and extensive radiological evaluation may determine a possible etiology in almost all cases of AP. Many patients have several possible risk factors, and uncertainty remains in establishing the definitive etiology.

Keywords: Acute pancreatitis, Etiology, Medicines, Drugs, Bile stones, Alcohol

Core tip: We conducted a study investigating a large cohort of patients admitted with acute pancreatitis to gain knowledge of the possible causes.