Etiological Factors of Non Alcohol Non Gallstone Related Acute Pancreatitis: A Cross sectional hospital based study from Medical College and Hospital, Kolkata, West Bengal

Abstract

Background Gall stone diseases and alcohol are the two most common causes of acute pancreatitis. The present work was undertaken to identify the various etiological factors in acute pancreatitis after excluding alcoholism and gall stone diseases. The etiology of an attack of non alcohol non gall stone acute pancreatitis is highly variable. The main objective was to identify the causing factor, because it can have an effect on the specific treatment of acute pancreatitis. . This is a rare cross- sectional study of its kind which is the first one to be reported from India. Materials and Methods A cross-sectional community based study was designed and conducted in Medical College and Hospital, Kolkata, West Bengal, India from July 2009 to June 2011. Z test and Chi square test were used to observe the variation between different variables and strength of the relationship with logistic regression. Odd ratios were calculated and their 95% confidence intervals (95% CI). p < 0.05 was considered as statistically significant. Results CMV was the commonest etiology of non alcohol and non gallstone acute pancreatitis 26.7% followed by HEV 6.7% and Pancreas Divisum 6.7%%, SOD 3.3%, EBV 3.3%, Mumps 3.3%, Hepatitis 3.3%, Tumour 3.3%, Choledochal cyst 3.3%,Drugs 3.3% and Gallstone 3.3%. Logistic regression analysis finding indicates that acute pancreatitis was found more prevalent in < 40 yrs [OR 2.076,95%(CI 0.339, 12.716)] and among patients having monthly income of <5000 rs/month yrs [OR 1.4,95%(CI 0.224, 8.768)] . According to the severity of CT grading, Patients had Grade D severity [OR 2.667,95%(CI 0.158, 45.141)], Grade C[OR 1.333,95%(CI 0.104, 17.098)] and Grade E [OR 1.333,95%(CI 0.88, 20.108)]as compared to Grade B severity of CT. Conclusion In the study an etiological factor was evident among almost 3/4th of the patients of non-alcoholic and non-gallstone pancreatitis. The most common etiological factors were CMV followed by HEV. These results rather suggests that the most diligent workup including a biliary microcrystal analysis, a sphincter of Oddi manometry and possible gene analysis for hereditary disorders may further reduce the apparently idiopathic group in the analysis of such patients. DOI: http://dx.doi.org/10.3126/nje.v4i3.10663 Nepal Journal of Epidemiology 2014; 4(3): 351-62

Etiopathogenesis of Non-Gall Stone Pancreatitis in Kashmir Valley- A Descriptive Hospital-Based Study

“…In our study, acute pancreatitis was mostly seen in married patients as shown in table 4 and graph 4, which matches with the study done by Banerjee I et al (2014) 6 did a crosssectional community-based study "Etiological Factors of Non-Alcohol Non-Gallstone Related Acute Pancreatitis" in their study found that married patients were more in number than unmarried subjects.…”

“…This is in variance to most of the studies. Banerjee I et al (2014) 6 did a cross-sectional communitybased study "Etiological Factors of Non-Alcohol Non-Gallstone Related Acute Pancreatitis" which was designed and conducted in Medical College and Hospital, Kolkata, West Bengal, India from July 2009 to June 2011, in their study most of the patients were <40 years of age (63.3%).…”