Etiology of acute pancreatitis

Mechanical	Gallstones, biliary sludge, ascariasis, periampullary diverticulum, pancreatic or periampullary cancer, ampullary stenosis, duodenal stricture or obstruction
Toxic	Ethanol, methanol, scorpion venom, organophosphate poisoning
Metabolic	Hyperlipidemia (types I, IV, V), hypercalcemia
Drugs	Didanosine, pentamidine, metronidazole, stibogluconate, tetracycline furosemide, thiazides, sulphasalazine, 5-ASA, L-asparaginase, azathioprine, valproic acid, sulindac, salicylates, calcium, estrogen
Infection	Viruses-mumps, coxsackie, hepatitis B, CMV, varicella-zoster, HSV, HIV
	Bacteria-mycoplasma, Legionella, Leptospira, salmonella
	Fungi-aspergillus
	Parasites-toxoplasma, cryptosporidium, Ascaris
Trauma	Blunt or penetrating abdominal injury, iatrogenic injury during surgery or ERCP (sphincterotomy)
Congenital	Cholodochocele type V, pancreas divisum*
Vascular	Ischemia, atheroembolism, vasculitis (polyarteritis nodosa, SLE)
Miscellaneous	Post ERCP, pregnancy, renal transplantation, alpha-1-antitrypsin deficiency
Genetic	CFTR, PRSS1, SPINK1, and other genetic mutations

*Whether pancreas divisum causes pancreatitis or is an incidental finding is controversial. 5-ASA: 5-aminosalicylic acid; CMV: cytomegalovirus; HSV: herpes simplex virus; HIV: human immunodeficiency virus; ERCP: endoscopic retrograde cholangiopancreatography; PRSS: protease serine; SPINK: serine protease inhibitor Kazal type; SLE: systemic lupus erythematosus; CFTR: cystic fibrosis transmembrane conductance regulator.

Graphic 78423 Version 5.0

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Etiology of acute pancreatitis