What are the causes of acute pancreatitis?

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

A commonly used mnemonic is:

I GET SMASHED

  • Idiopathic
  • Gall stones (50%)
  • Ethanol (20%)
  • Trauma
  • Steroids
  • Mumps and other viruses (EBV, CMV, HIV)
  • Autoimmune diseases (SLE, polyarteritis nodosa, pregnancy)
  • Scorpion stings
  • Hypercalcemia, hyperlipidemia, hypothermia, hypotension (ischemia)
  • ERCP, emboli
  • Drugs