Obstructive / Mechanical
- Gall stones (50%)
- Malignancy:
- Pancreatic ductal carcinoma
- Ampullary carcinoma
- Islet cell tumour
- Sarcoma
- Lymphoma
- ERCP (5% of procedures)
- Trauma
- Penetrating duodenal ulcer
- Congenital abnormalities
- Cystic fibrosis
Parenchymal
- Alcohol (20%)
- Autoimmune / vasculitic disease
- Scorpion stings
Systemic
- Hypoxemia / ischaemia
- Drugs
- Hypothermia
- Hypercalcemia
- Hypertriglyceridemia (>20mmol/L)
- Viruses (Mumps, HIV, CMV, EBV)
- Other infections
- Venovenous - requires an external pump