Biliary sludge: a risk factor for 'idiopathic' pancreatitis?
Idiopathic acute pancreatitis is common. Recent evidence suggests that biliary sludge may be the etiology in many patients with this disorder. In this case-control study, admission ultrasound examinations of patients with idiopathic pancreatitis, patients with acute alcohol-associated pancreatitis and a control group were compared. Biliary sludge was found in seven of 21 patients (33%) with idiopathic pancreatitis, two of 25 (8%) with acute alcohol-associated pancreatitis and one of 63 controls (1.6%). Comparison of idiopathic pancreatitis patients with both acute alcohol-associated pancreatitis patients and controls for the presence of sludge revealed odds ratios of 31.0 (95% CI 3.5 to 273) and 5.8 (95% CI 1.1 to 32.0), respectively. Also observed was a trend towards higher levels of liver enzymes, bilirubin and amylase in patients with idiopathic pancreatitis who had sludge identified. This study provides further evidence linking biliary sludge with a significant proportion of patients with idiopathic acute pancreatitis.
Marotta
P J
PJ
Department of Medicine, University of Western Ontario, London.
Gregor
J C
JC
Taves
D H
DH
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D001646:Bile; D001663:Bilirubin / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D019512:Pancreatitis, Alcoholic / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography
D000681:Amylases; D001663:Bilirubin