Although studies on acute pancreatitis have been widely reported in the literature, there is much less data available on recurrent pancreatitis.
In an attempt to rectify this lack of information, Dr Lucio Gullo and colleagues from across Europe have sought to determine the relative frequency and mortality of recurrent acute pancreatitis, and also to update current thinking on the etiology of this condition.
The research group selected 288 patients with recurrent pancreatitis from a cohort of 1068 subjects with acute pancreatitis that had been included in a previous European study.
All patients were admitted to a hospital with an attack of acute pancreatitis between January 1990 and December 1994. Data for each patient was recorded on a standardized form.
In the initial study population (n = 1068), almost 79% were men, and the mean age was 43 years (range 16 to 95 years).
Alcohol was found to be the most frequent etiological factor, accounting for 57% of patients with acute pancreatitis.
Gallstones were the next most common cause of acute pancreatitis (57%), followed by other factors (7.6%) or no identified factor (10.4%).
| Alcoholic pancreatitis:|
6.9% mortality rate
30% mortality rate
| The American Journal of Gastroenterology |
Of the 288 patients, 17 (5.9%) died, all of whom had necrotizing pancreatitis.
Among all those patients with this condition (141 of 288), the mortality rate was just over 12%.
These percentages were lower than those for patients who had a single attack (8.5% and 18.6%, respectively), but not to a statistically significant degree.
Mortality was significantly lower among patients with alcoholic pancreatitis (6.9%) than among those with biliary (30%) or idiopathic pancreatitis (25%).
Most of the deaths (82.4%) occurred at the second attack of pancreatitis.
The authors conclude that acute recurrent pancreatitis remains a frequent disease, with alcohol being the most frequent etiological factor.
They add that mortality is similar to that of a single episode of acute pancreatitis, and it is significantly lower among patients with alcohol as the etiology.