Guest guest Posted July 25, 2003 Report Share Posted July 25, 2003 Causes: a.. The major causes are long-standing alcohol consumption and biliary stone disease. a.. In developed countries, the most common cause of acute pancreatitis is alcohol abuse. a.. On the cellular level, ethanol leads to intracellular accumulation of digestive enzymes and their premature activation and release. b.. On the ductal level, ethanol increases the permeability of ductules, which allow enzymes to reach the parenchyma, resulting in pancreatic damage. c.. Ethanol increases the protein content of the pancreatic juice and decreases bicarbonate levels and trypsin inhibitor concentrations. This leads to the formation of protein plugs that block the pancreatic outflow and obstruction. a.. Another major cause of acute pancreatitis is biliary stone disease (eg, cholelithiasis, choledocholithiasis). A biliary stone may lodge in the pancreatic duct or ampulla of Vater and obstruct the pancreatic duct, leading to extravasation of enzymes into the parenchyma. a.. Minor causes of acute pancreatitis a.. Medications, including azathioprine, corticosteroids, sulfonamides, thiazides, furosemides, NSAIDs, mercaptopurine, methyldopa, and tetracyclines a.. Endoscopic retrograde cholangiopancreatography (ERCP) a.. Hypertriglyceridemia (When the triglyceride (TG) level exceeds 1000 mg/U, an episode of pancreatitis is more likely.) a.. Peptic ulcer disease a.. Abdominal or cardiopulmonary bypass surgery, which may insult the gland by ischemia a.. Trauma to the abdomen or back, resulting in sudden compression of the gland against the spine posteriorly a.. Carcinoma of the pancreas, which may lead to pancreatic outflow obstruction a.. Viral infections, including mumps, sackievirus, cytomegalovirus (CMV), hepatitis virus, Epstein-Barr virus (EBV), and rubella a.. Bacterial infections, such as mycoplasma a.. Intestinal parasites, such as ascaris, which can block the pancreatic outflow a.. Pancreas divisum a.. Scorpion and snake bites a.. Vascular factors, such as ischemia or vasculitis Mark E. Armstrong www.top5plus5.com NW Chapter Rep Pancreatitis Association, International Quote Link to comment Share on other sites More sharing options...
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