Etiology of acute pancreatitis--a multi-center study in Taiwan.
OBJECTIVE
Little is known about the etiology of acute pancreatitis in Taiwan. The aim of this study was to evaluate the current etiology of acute pancreatitis in Taiwan by a multi-center cooperative study.


METHODS
Patients with acute pancreatitis were collected from 8 major leading hospitals located at northern, southern, middle and eastern Taiwan from July 1, 1998 to June 30, 2000. The diagnosis of acute pancreatitis was based on characteristic clinical signs and symptoms and three-fold elevation of serum amylase/lipase level or positive evidence in imaging studies. The etiology was attributed to alcohol, gallstones, hypertriglyceridemia, miscellaneous causes, and idiopathic causes.


RESULTS
In total 1,193 patients with acute pancreatitis were identified. There were 852 (71.4%) men and 341 (28.6%) women with a mean age of 52.5 years, ranging from 9 to 100 years. Etiology was identified as alcohol in 423 (33.6%), gallstones in 407 (34.1%), hypertriglyceridemia in 147 (12.3%), miscellaneous causes in 109 (9.1%), and idiopathic causes in 107 (9.0%). Patients with alcohol-related acute pancreatitis were the youngest (mean age: 41.5 years), while those with gallstone pancreatitis were the eldest (mean age: 64.1 years) (p < 0.001). The predominant cause of acute pancreatitis in women is gallstones, while alcohol is the leading cause of acute pancreatitis in Taiwanese males. In northern Taiwan, gallstone is the major cause of acute pancreatitis, while alcohol is the predominant etiology in middle, southern, and eastern Taiwan.


CONCLUSIONS
Alcohol has become the predominant cause of acute pancreatitis in Taiwan recently. Ecological and gender differences play important roles in the etiology of acute pancreatitis in Taiwan.
Chang
Ming-Chu
MC
Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.
Su
Cheng-Hsi
CH
Sun
Maw-Soan
MS
Huang
Shih-Che
SC
Chiu
Cheng-Tang
CT
Chen
Ming-Chen
MC
Lee
King-Teh
KT
Lin
Chun-Che
CC
Lin
Jaw-Town
JT
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications*; D005260:Female; D042882:Gallstones / Q000150:complications*; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D012189:Retrospective Studies; D013624:Taiwan