Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 46

Establishing an etiological diagnosis is extremely important in patients with AP to identify the cause and prevent recurrence. Alcohol and gallstones are the most common causes of AP. Biliary pancreatitis is diagnosed if there is elevation of hepatic transaminases on the first day of AP which normalizes in a few days in a patient with gallstones and/or a dilated bile duct. In patients with suspicion of biliary etiology but without demonstrable gallstones, subsequent transabdominal/endoscopic ultrasound after recovery may demonstrate gallstones. Heavy alcohol consumption (>60 g/day) for at least five years may cause alcoholic pancreatitis. Hypercalcemia and HTG are important metabolic causes of AP. Smoking is a risk factor for AP. Patients with idiopathic pancreatitis aged over 50 years should be evaluated for occult pancreatobiliary malignancy if there is no other obvious cause of AP. Patients with AP should undergo an algorithmic investigative work‐up.