Acute Pancreatitis — Another Piece of the Puzzle?

Recent decades have added little to our knowledge of the causes of pancreatitis.1 In the United States, cholelithiasis and chronic alcoholism together account for about 80 percent of cases. About 5 to 10 percent of cases are caused by diverse factors, such as hyperlipidemia, ductal obstruction, viral infection, various drugs, hypercalcemia, and impaired pancreatic perfusion. Rarely, other causes are recognized, but the remaining 10 to 15 percent of cases are still labeled "idiopathic." Even when the cause is known, the precise mechanisms by which each of these factors initiates the autodigestive process in the pancreas remain obscure. Much of what . . .