Chronic pancreatitis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

The causes of pancreatitis are many but at least 70% of adult cases are associated with chronic alcohol use, and most patients have consumed more than 80 g/day of alcohol over six to twelve years.[1][2]

  • Major associations with chronic pancreatitis [3][4][5]
    • Alcohol[6][7][8][9][10][11]
      • ≥80 g of ethanol consumption a day for at least 5 years
      • Most common cause in men
      • Least common cause in women[12]
    • Autoimmunity
      • Autoimmune pancreatitis
      • Associated with other systemic disorders (Sjogren syndrome, inflammatory bowel disease, or primary biliary cholangitis)
    • Obstruction
      • Fibrotic stenosis of either the papilla of Vater or the main pancreatic duct
      • Trauma
      • Pseudocysts
      • Stones
      • Tumors
      • Pancreas divisum
    • Anatomic variations
      • Pancreas divisum
      • Paraduodenal pancreatitis (Cystic dystrophy of the duodenal wall/groove pancreatitis)
    • Metabolic or systemic diseases
      • Hypercalcemia
      • Hypertryglyceridemia
      • Hyperparathyroidism
      • Systemic lupus erythematosus
    • Genetic
      • CFTR
      • CTRC
      • SPINK1
      • PRSS1 gene mutations
      • Hereditary pancreatitis
    • Idiopathic

References

  1. Nair RJ, Lawler L, Miller MR (2007). "Chronic pancreatitis". Am Fam Physician. 76 (11): 1679–88. PMID 18092710.
  2. Mitchell RMS et al. Pancreatitis. Lancet 2003; 361: 1447–55
  3. Mitchell RMS et al. Pancreatitis. Lancet 2003; 361: 1447–55
  4. Frulloni et al. Chronic pancreatitis: Report from a multicenter Italian survey (PanCroInfAISP) on 893 patients. Dig Liver Dis. 2009 Apr;41(4):311-7
  5. Adsay NV et al. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying "cystic dystrophy of heterotopic pancreas", "para-duodenal wall cyst", and "groove pancreatitis". Semin Diagn Pathol. 2004 Nov;21(4):247-54.
  6. Lu Z, Karne S, Kolodecik T, Gorelick FS (2002). "Alcohols enhance caerulein-induced zymogen activation in pancreatic acinar cells". Am. J. Physiol. Gastrointest. Liver Physiol. 282 (3): G501–7. doi:10.1152/ajpgi.00388.2001. PMC 2830557. PMID 11842000.
  7. Bisceglie AM, Segal I (1984). "Cirrhosis and chronic pancreatitis in alcoholics". J. Clin. Gastroenterol. 6 (3): 199–200. PMID 6725910.
  8. Wilson JS, Bernstein L, McDonald C, Tait A, McNeil D, Pirola RC (1985). "Diet and drinking habits in relation to the development of alcoholic pancreatitis". Gut. 26 (9): 882–7. PMC 1432860. PMID 4029715.
  9. Whitcomb DC (2003). "Genetic predisposition to alcoholic chronic pancreatitis". Pancreas. 27 (4): 321–6. PMID 14576495.
  10. Maisonneuve P, Lowenfels AB, Müllhaupt B, Cavallini G, Lankisch PG, Andersen JR, Dimagno EP, Andrén-Sandberg A, Domellöf L, Frulloni L, Ammann RW (2005). "Cigarette smoking accelerates progression of alcoholic chronic pancreatitis". Gut. 54 (4): 510–4. doi:10.1136/gut.2004.039263. PMC 1774435. PMID 15753536.
  11. Morton C, Klatsky AL, Udaltsova N (2004). "Smoking, coffee, and pancreatitis". Am. J. Gastroenterol. 99 (4): 731–8. doi:10.1111/j.1572-0241.2004.04143.x. PMID 15089909.
  12. Coté GA, Yadav D, Slivka A, Hawes RH, Anderson MA, Burton FR, Brand RE, Banks PA, Lewis MD, Disario JA, Gardner TB, Gelrud A, Amann ST, Baillie J, Money ME, O'Connell M, Whitcomb DC, Sherman S (2011). "Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis". Clin. Gastroenterol. Hepatol. 9 (3): 266–73, quiz e27. doi:10.1016/j.cgh.2010.10.015. PMC 3043170. PMID 21029787.


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