Acute Recurrent Pancreatitis

History, physical examination, simple laboratory and radiological tests, and endoscopic retrograde cholangiopancreatography (ERCP) are able to establish the cause of recurrent acute pancreatitis in 70% to 90% of patients. Dysfunction of the biliary and/or pancreatic sphincter, as identified by sphin...

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Main Author: Glen A Lehman
Format: Article
Language:English
Published: Wiley 2003-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2003/781237
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author Glen A Lehman
author_facet Glen A Lehman
author_sort Glen A Lehman
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description History, physical examination, simple laboratory and radiological tests, and endoscopic retrograde cholangiopancreatography (ERCP) are able to establish the cause of recurrent acute pancreatitis in 70% to 90% of patients. Dysfunction of the biliary and/or pancreatic sphincter, as identified by sphincter of Oddi manometry, accounts for the majority of the remaining cases. The diagnosis may be missed if the pancreatic sphincter is not evaluated. Pancreas divisum is a prevalent congenital abnormality that is usually innocuous but can lead to recurrent attacks of acute pancreatitis or abdominal pain. In select cases, endoscopic sphincterotomy of the minor papilla can provide relief of symptoms and prevent further attacks. A small proportion of patients with idiopathic pancreatitis have tiny stones in the common bile duct (microlithiasis). Crystals can be visualized during microscopic analysis of bile that is aspirated at the time of ERCP. Neoplasia is a rare cause of pancreatitis, and the diagnosis can usually be established by computerized tomography or ERCP. A wide variety of medications can also cause recurrent pancreatitis. ERCP, sphincter of Oddi manometry, and microscopy of aspirated bile should be undertaken in patients with recurrent pancreatitis in whom the diagnosis is not obvious.
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spelling doaj-art-845e7a55e5ea4e38aac7a62b4b6a2e102025-08-20T03:37:11ZengWileyCanadian Journal of Gastroenterology0835-79002003-01-0117638138310.1155/2003/781237Acute Recurrent PancreatitisGlen A Lehman0Division of Gastroenterology/Hepatology, Indiana University Medical Center, 550 North University Boulevard, Suite 2300, Indianapolis, Indiana, USAHistory, physical examination, simple laboratory and radiological tests, and endoscopic retrograde cholangiopancreatography (ERCP) are able to establish the cause of recurrent acute pancreatitis in 70% to 90% of patients. Dysfunction of the biliary and/or pancreatic sphincter, as identified by sphincter of Oddi manometry, accounts for the majority of the remaining cases. The diagnosis may be missed if the pancreatic sphincter is not evaluated. Pancreas divisum is a prevalent congenital abnormality that is usually innocuous but can lead to recurrent attacks of acute pancreatitis or abdominal pain. In select cases, endoscopic sphincterotomy of the minor papilla can provide relief of symptoms and prevent further attacks. A small proportion of patients with idiopathic pancreatitis have tiny stones in the common bile duct (microlithiasis). Crystals can be visualized during microscopic analysis of bile that is aspirated at the time of ERCP. Neoplasia is a rare cause of pancreatitis, and the diagnosis can usually be established by computerized tomography or ERCP. A wide variety of medications can also cause recurrent pancreatitis. ERCP, sphincter of Oddi manometry, and microscopy of aspirated bile should be undertaken in patients with recurrent pancreatitis in whom the diagnosis is not obvious.http://dx.doi.org/10.1155/2003/781237
spellingShingle Glen A Lehman
Acute Recurrent Pancreatitis
Canadian Journal of Gastroenterology
title Acute Recurrent Pancreatitis
title_full Acute Recurrent Pancreatitis
title_fullStr Acute Recurrent Pancreatitis
title_full_unstemmed Acute Recurrent Pancreatitis
title_short Acute Recurrent Pancreatitis
title_sort acute recurrent pancreatitis
url http://dx.doi.org/10.1155/2003/781237
work_keys_str_mv AT glenalehman acuterecurrentpancreatitis