A systematic review and meta-analysis of the aetiology of acute pancreatitis

Zilio, Mariana Blanck; Eyff, Tatiana Falcão; Azeredo-da-Silva, André Luís Ferreira; Bersch, Vivian Pierri; Osvaldt, Alessandro Bersch

doi:10.1016/j.hpb.2018.08.003

Cited by 68 publications

(56 citation statements)

References 54 publications

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“…The three most common etiologies are biliary in 30-40% of cases, alcoholic in 30-40% of cases and idiopathic in 20-30% [1][2][3][4]. Despite this, in our sample from the Hospital in Porto Alegre, Brazil we observed a much higher frequency of acute biliary pancreatitis (ABP) responsible for 77% of the cases and less of acute alcoholic pancreatitis (AAP), responsible for only 8% of the cases [5]. Other causes of pancreatitis include hypertriglyceridemia, hypercalcemia, trauma, drugs, surgical and endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), neoplasms, infectious diseases, autoimmune diseases, and genetic causes.…”

Section: Introductionmentioning

confidence: 56%

Systematic Review of Most Common Causes of Acute Pancreatitis

Roberto¹,

Zilio²,

Lucas³

et al. 2019

Preprint

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Introduction: Cholelithiasis and consumption of alcohol are the most frequent causes of acute pancreatitis (AP), accounting for about 30 to 40% of the cases, respectively. The frequency of acute biliary pancreatitis is high in a certain population in Brazil. Objective: To estimate the global frequencies of acute biliary pancreatitis (ABP), acute alcoholic pancreatitis (AAP) and the cases considered as acute idiopathic pancreatitis (AIP) in studies published from October 2006 to December 31, 2018. Methods: A systematic review of observational studies was performed from October 2006 to December 31, 2018. A meta-analysis by the random effects model was used to calculate the frequencies of global ABP, AIP and AAP and subgroups. Results: Forty-six studies representing 2,341,007 AP cases were included in 36 countries. The overall estimate for acute biliary pancreatitis (ABP) was 41.6% (95% CI 39.2-44.1), followed by acute alcoholic pancreatitis (AAP) with 20.5% (95% CI) 16.6- 24.6) and acute idiopathic pancreatitis (AIP) in 18.3% (95% CI 15.1-27.7). Conclusion: ABP is the most prevalent etiology of AP, being two times more frequent than second-placed pancreatitis. Latin America has a frequency for ABP much higher than the rest of the world. The importance of the etiologic diagnosis is the treatment of the cause for prevention of recurrence.

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Section: Introductionmentioning

confidence: 56%

Systematic Review of Most Common Causes of Acute Pancreatitis

Roberto¹,

Zilio²,

Lucas³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…To provide early treatment and prevent further episodes, it is essential to determine the etiology of pancreatitis. In up to 22 % of cases [2] the cause cannot be identified during initial evaluation and recurrences may lead to chronic pancreatitis with limited therapeutic options [3].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound (EUS) in pancreatic masses with inconclusive radiologic workup – a case series and short review of the literature

et al. 2021

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Endoscopic ultrasound (EUS) is a very sensitive examination to detect pancreatic masses and can provide useful information in cases where conventional radiologic workup remains inconclusive. We present three cases in which EUS was decisive in establishing the correct diagnosis. Case 1: A 74-year-old female was hospitalized because of acute pancreatitis. Medical history, CT and MRI gave no clue to etiology, but EUS diagnosed a small pancreatic tumor. Case 2: A female patient was admitted because of abdominal pain and weight loss. While MRI suspected a pancreatic tumor, EUS showed typical features of autoimmune pancreatitis. Case 3: A 50-year-old patient was hospitalized with cachexia, ascites and pulmonary embolism. At first, a pancreatic tumor was suspected, but EUS showed a cystic lesion with a solid component (pancreatic pseudocyst).

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“…The leading causes of acute pancreatitis are represented by gallstones (28-38%) and alcohol consumption (19-41%), followed by [10]. Based on neoplastic etiology, frequently involved are exocrine pancreatic tumors or metastatic dissemination from other organs, NENs being a rare cause [11,12].…”

Section: Discussionmentioning

confidence: 99%

Duodenal large-cell neuroendocrine carcinoma as unusual cause of acute pancreatitis

et al. 2020

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Early identification of acute pancreatitis etiology is essential for choosing the best therapeutic management. The main causes are cholelithiasis and alcohol consumption. Tumors that obstruct the main pancreatic duct are uncommon causes of acute pancreatitis. Duodenal neuroendocrine tumors are rare entities and may be exceptional causes of acute pancreatitis. A 57-year-old male, with associated severe cardiovascular pathology, was admitted with clinical and biological picture of acute pancreatitis. Biliary and alcoholic causes were excluded. Abdominal contrast-enhanced computed tomography scan identified circumferential wall thickening of the second segment of the duodenum with peri-ampullary and papillary nodular non-homogenous contrast enhancement aspect. Upper gastrointestinal endoscopy described irregular hypertrophic duodenal mucosal folds and biopsies were performed. The histopathological diagnosis after immunohistochemistry tests was duodenal large-cell neuroendocrine carcinoma. The patient was referred to the oncology clinic and palliative treatment was initiated. The evolution was marked by additional complications due to the tumor evolutionupper gastrointestinal bleeding and obstructive jaundice, conservatory treated and, respectively, by interventional radiology technique. This case illustrates that, although often obvious, etiological diagnosis approach of acute pancreatitis can be sometimes challenging. Tumor cause is infrequent and requires thorough work-up, as the treatment is different. Although extremely rare and sometimes with mild clinical presentation, duodenal neuroendocrine carcinomas may have dramatic onset and evolution, involving extensive therapeutic resources.

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A systematic review and meta-analysis of the aetiology of acute pancreatitis

Cited by 68 publications

References 54 publications

Systematic Review of Most Common Causes of Acute Pancreatitis

Systematic Review of Most Common Causes of Acute Pancreatitis

Endoscopic ultrasound (EUS) in pancreatic masses with inconclusive radiologic workup – a case series and short review of the literature

Duodenal large-cell neuroendocrine carcinoma as unusual cause of acute pancreatitis

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