Etiology of acute pancreatitis

Etiology of acute pancreatitis is multifaceted and not enough is yet known.
Established a clear link between acute pancreatitis and diseases of the biliary tract. According to statistics, 60 - 80% of patients with acute pancreatitis had prior or concomitant disease of the bile ducts. The colics often directly precede the development of pancreatitis.
According to Molander and Bell (1946), autopsy 160 patients who died of acute pancreatitis, gall stones were found in 36% of men and 68% of women, and on autopsy of the dead from other illnesses at the same age - only 6% of men and 10% of women.
Explanation of the link between disease biliary tract and acute pancreatitis find the possibility of penetration of bile into the pancreatic duct (biliopancreatic reflux) and enzyme activation of pancreatic juice. However, the flow of bile in Virunga duct is possible only under certain anatomical conditions, if the common bile duct is with pancreatic duct General ampoule, and a blockage occurs below the level of their merger. Experimental and clinical and x-ray observations confirm the possibility of this mechanism. The immediate cause of receipt of bile into the pancreatic duct can be spasm of the sphincter of Oddi or corking of capsules stone and jelchnokamenna disease. Paralytic dyskinesia sphincter may create conditions for penetration into the pancreatic duct and duodenal contents. The pressure increase in the duodenum may occur when cough, vomiting, and flatulence.
Despite the possibility of receipt of bile into the pancreatic duct, causal role canalicular mechanism of occurrence of acute pancreatitis remains a subject of debate, as the General ampoule bile and pancreatic duct meets unstable. Apparently, throwing bile in Virunga duct is possible but not the only cause of acute pancreatitis.
In addition to the reflux of bile into the pancreatic duct, etiological importance attached to the violation of the outflow of pancreatic juice, due to any reasons (for example, a blockage of the bile or pancreatic stones, Ascaris, a violation of the outflow caused by spasm of the sphincter of Oddi, swelling papillae or mucous membrane ducts etc). This view to some extent also explains the frequent combination of acute pancreatitis with diseases of the biliary tract.
Acute pancreatitis is often develops from chronic and acute alcohol poisoning.
Etiological significance of alcoholism is known already for a long time, no doubt and confirmed by statistical observations. The development of acute pancreatitis is often directly precedes the use of significant quantities of alcohol. According to Bockus (1965), in 60% of patients with acute pancreatitis in history was chronic alcoholism.
According to Howard (1960), 353 cases of acute pancreatitis alcohol intoxication was reliable cause disease in 27% of patients.
The connection of acute pancreatitis with family hyperlipemia and with adenoma of the parathyroid glands. The disease may develop due to nutritional disorders, as with overeating and malnutrition.
The cause of the disease may be the defeat of vessels of the body (embolism arteries throm, periarteritis nodosa), suppurative processes in the abdominal cavity (appendicitis, cholecystitis), physical trauma (for example, bruised belly, operations on the stomach and biliary tract), various intoxication, infection, allergic States, etc.
Among infectious diseases, causing sometimes mild forms of acute pancreatitis, you can specify the mumps and Botkin's disease. For the most part lesions of the pancreas in these cases occur latent. We observed acute pancreatitis in patients with rheumatism.
Thus, the etiological principle it is possible to distinguish alcoholic, toxic, infectious, allergic, post-traumatic, septikopiemicheskih, thromboembolic, nutritional, metabolic pancreatitis. Almost similar classification uncomfortable, so pancreatitis often distinguished by postmortem principle, in particular hemorrhagic and fat necrosis of the pancreas, oedema and purulent pancreatitis. Clinical classification includes heavy and light form of acute pancreatitis.