In countries with a high prevalence of acute pancreatitis the main cause is alcohol, whilst in low-prevalence countries it is mainly related to biliary disease. (1)
The most common causes of acute pancreatitis in adults are:(2)
- gallstones in the lower end of the common bile duct - 50%
- risk is higher in patients with gallstones smaller than 5 mm, microlithiasis, or biliary sludge
- a linear increase in the incidence of gallstone pancreatitis across the UK and European countries has been observed in several epidemiological studies
- incidence increases with age in both men and women
- women over the age of 60 years is at higher risk
- alcohol - 25%
- incidence of alcohol-induced pancreatitis is much lower in the UK when compared with European studies
- is more common in middle-aged men
- idiopathic - 20%–34%
- incidence is similar in men and in women
- rare causes – 5%
- e.g. drugs (for example, valproate, steroids, azathioprine), endoscopic retrograde cholangiopancreatography, hypertriglyceridaemia or lipoprotein lipase deficiency, hypercalcaemia, pancreas divisum, and some viral infections (mumps, coxsackie B4)
Regional difference with regard to the aetiology have been observed. In the UK, around 50% of cases are caused by gallstones, 25% by alcohol, and 25% by other factors. (3) The most common cause worldwide is alcohol consumption.
Reference
- Yadav D, O'Connell M, Papachristou GI; Natural history following the first attack of acute pancreatitis. Am J Gastroenterol. 2012 Jul;107(7):1096-103
- Mederos MA, Reber HA, Girgis MD. Acute Pancreatitis: A Review. JAMA. 2021 Jan 26;325(4):382-90.
- National Institute for Health and Care Excellence. Pancreatitis. December 2020 [internet publication].