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acute biliary pancreatitis
Friday 3 September 2010
The etiology of acute biliary pancreatitis (ABP) is multifactorial and complex.
Passage of small gallbladder stones or biliary sludge through the ampulla of Vater seems to be important in the pathogenesis of ABP.
Other factors, such as anatomical variations associated with an increased biliopancreatic reflux, bile and pancreatic juice exclusion from the duodenum, and genetic factors might contribute to the development of ABP.
A diagnosis of a biliary etiology in acute pancreatitis is supported by both laboratory and imaging investigations.
An increased serum level of alanine aminotransferase (>1.0 microkat/l) is associated with a high probability of gallstone pancreatitis (positive predictive value 80-90%).
Confirmation of choledocholithiasis is most accurately obtained using endoscopic ultrasonography or magnetic resonance cholangiopancreatography.
References
Etiology and diagnosis of acute biliary pancreatitis. van Geenen EJ, van der Peet DL, Bhagirath P, Mulder CJ, Bruno MJ. Nat Rev Gastroenterol Hepatol. 2010 Sep;7(9):495-502. PMID: 20703238