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