Common Causes

• Gallstones (including microlithiasis)
• Alcohol (acute and chronic alcoholism)
• Hypertriglyceridemia
• Endoscopic retrograde cholangiopancreatography (ERCP), especially after biliary manometry
• Trauma (especially blunt abdominal trauma)
• Postoperative (abdominal and nonabdominal operations)
• Drugs (azathioprine, 6-mercaptopurine, sulfonamides, estrogens, tetracycline, valproic acid, anti-HIV medications)
• Sphincter of Oddi dysfunction

Uncommon Causes

• Vascular causes and vasculitis (ischemic-hypoperfusion states after cardiac surgery)
• Connective tissue disorders and thrombotic thrombocytopenic purpura (TTP)
• Cancer of the pancreas
• Hypercalcemia
• Periampullary diverticulum
• Pancreas divisum
• Hereditary pancreatitis
• Cystic fibrosis
• Renal failure

Rare Causes

• Infections (mumps, coxsackievirus, cytomegalovirus, echovirus, parasites)
• Autoimmune (e.g., Sjögren’s syndrome)

Causes to Consider in Patients with Recurrent Bouts of Acute Pancreatitis without an Obvious Etiology

• Occult disease of the biliary tree or pancreatic ducts, especially microlithiasis, sludge
• Drugs
• Hypertriglyceridemia
• Pancreas divisum
• Pancreatic cancer
• Sphincter of Oddi dysfunction
• Cystic fibrosis
• Idiopathic