Journal of the Formosan Medical Association
Volume 105, Issue 7 , Pages 550-555, 2006

Etiology, Severity and Recurrence of Acute Pancreatitis in Southern Taiwan

  • Chun-Hao Chen

      Affiliations

    • Department of Internal Medicine, Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Municipal United Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Chia-Yen Dai

      Affiliations

    • Department of Internal Medicine, Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Nai-Jen Hou

      Affiliations

    • Department of Internal Medicine, Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Shinn-Cherng Chen

      Affiliations

    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Wan-Long Chuang

      Affiliations

    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Ming-Lung Yu

      Affiliations

    • Department of Internal Medicine, Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ming-Lung Yu, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 13 June 2005; received in revised form 17 August 2005; accepted 10 January 2006.

Article Outline

Background/Purpose

Changes in lifestyle have led to variation in the etiologies of acute pancreatitis in different areas of Taiwan. This study investigated the etiologies and factors associated with severity and recurrence of acute pancreatitis in southern Taiwan.

Methods

Eighty acute pancreatitis patients (M/F: 64/16), including 53 (66.2%) with alcohol abuse, 16 (20%) with biliary disease, five (6.3%) with hyperlipidemia, and six (7.5%) with other risk factors, etiologies or idiopathic disease, were included. The mean follow-up period was 20 months. Contrast-enhanced computed tomography (CT) was used to assess the severity of acute pancreatitis.

Results

Biliary pancreatitis was significantly associated with females while alcoholic pancreatitis occurred predominantly in males. Univariate analysis showed that male gender, alcoholic pancreatitis, and elevated serum triglyceride (>170 mg/dL) were significantly associated with severe acute pancreatitis. Multivariate logistic regression analysis revealed that male gender and abnormal serum triglyceride were independent risk factors for severity. Alcohol abuse was an independent risk factor for recurrent pancreatitis.

Conclusion

Alcoholic pancreatitis was the major etiology of acute pancreatitis in southern Taiwan, exhibiting a strong male predominance and higher risk of severe CT grading. Abnormal serum triglyceride was independently associated with the severity of acute pancreatitis. Alcoholic pancreatitis had a higher risk of recurrence than other etiologies.

Key Words:  alcoholism , etiology , gallstone , hypertriglyceridemia , pancreatitis , Taiwan

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Uhl W , Isenmann R , Curti G , et al.   Influence of etiology on the course and outcome of acute pancreatitis . Pancreas . 1996;13:335–343
  2. Corfield AP , Cooper MJ , Williamson RCN . Acute pancreatitis: a lethal disease of increasing incidence . Gut . 1995;26:724–729
  3. Thompson SR , Hendry WS , McFarlane GA . Epidemiology and outcome of acute pancreatitis . Br J Surg. . 1987;74:398–401
  4. Sakorafas GH , Tsiotou AG . Etiology and pathogenesis of acute pancreatitis: current concepts . J Clin Gastroenterol . 2000;30:343–356
  5. Beckingham IJ , Bornman PC . Acute pancreatitis . Br Med J . 2001;322:595–598
  6. Raffaele P , Paola B , Antonio M . Severity of acute pancreatitis: relationship with etiology, sex and age . Hepatogas-troenterology . 1998;45:1859–1864
  7. Tsai YT . Acute pancreatitis, introduction: incidence, etiology and mortality . Gastroenterol J Taiwan . 1987;1:2
  8. Chang MC , Su CH , Sun MS , et al.   Etiology of acute pancreatitis-A multi-center study in Taiwan . Hepatogas-troenterology . 2003;50:1655–1657
  9. Greenberger NJ , Toskes PP . Acute and chronic pancreatitis . In:  Braunwald E ,  Fauci AS ,  Kasper DL , et al. editor. Harrison's Principles of Internal Medicine . International edition. New York: McGraw-Hill; 2001;p. 1792–1803
  10. DiMagno EP , Chari S . Acute pancreatitis . In:  Feldman M ,  Friedman LS ,  Sleisenger MH editor. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . Philadelphia: Saunders; 2002;p. 913–937
  11. Fortson MR , Freedman SN , Webster PD . Clinical assessment of hyperlipidemic pancreatitis . Am J Gastroenterol . 1995;90:2134–2139
  12. Simchuk EJ , Traverso LW , Nukui Y , et al.   Computed tomography severity index is a predictor of outcomes for severe pancreatitis . Am J Surg. . 2000;179:352–355
  13. Balthazar EJ . Acute pancreatitis: assessment of severity with clinical and CT evaluation . Radiology . 2002;223:603–613
  14. Attili AF , Carulli N , Roda E , et al.   Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis . Am J Epidemiol . 1995;141:158–165
  15. Olah A , Belagyi T , Wellner I , et al.   Correlation of alcohol consumption and pancreatitis in Hungary . Magy Seb . 2000;53:3–6
  16. Lankisch PG , Burchard-Reckert S , Petersen M , et al.   Etiology and age have only a limited influence on the course of acute pancreatitis . Pancreas . 1996;13:344–349
  17. Yuasa C , Miyoshi O , Fukui K , et al.   Hyperlipidemia and early pancreatic injury induced by ethanol intake in rats . J Nutr Sci Vitaminol (Tokyo) . 2000;46:297–301
  18. Lechleitner M , Ladner E , Seyr M , et al.   Hypertrigly-ceridemia and acute pancreatitis . Acta Med Austriaca . 1994;21:125–128
  19. Athyros VG , Giouleme OI , Nikolaidis NL , et al.   Long-term follow-up of patients with acute hypertriglyceridemia-induced pancreatitis . J Clin Gastroenterol . 2002;34:472–475
  20. Piolot A , Nadler F , Cavallero E , et al.   Prevention of recurrent acute pancreatitis in patients with severe hyper-triglyceridemia: value of regular plasmapheresis . Pancreas . 1996;13:96–99

PII: S0929-6646(09)60149-2

doi:10.1016/S0929-6646(09)60149-2

Journal of the Formosan Medical Association
Volume 105, Issue 7 , Pages 550-555, 2006

Article Tools