title: Prospective evaluation of the aetiological profile of acute pancreatitis in young adult patients.
abstract: BACKGROUND
  The aetiologies of acute pancreatitis in young adult patients are poorly known.
  
  
  OBJECTIVE
  To prospectively evaluate the causes of acute pancreatitis in patients aged less than 35 years.
  
  
  METHODS
  Overall, 309 consecutive patients admitted to our centre for acute pancreatitis received first-line investigations, including medical history, standard laboratory tests, abdominal ultrasound and computed tomography. If no aetiology was found, second-line investigations were performed, including endoscopic ultrasound, magnetic-resonance cholangiopancreatography and genetic testing in cases of idiopathic pancreatitis.
  
  
  RESULTS
  Overall, 66 patients aged between 16 and 35 years were included. After first-line investigations, 49% of cases of acute pancreatitis remained idiopathic. Second-line investigations reduced this rate to 21%. The frequency of aetiologies for acute pancreatitis significantly differed in adults aged ≤ 35 compared to those aged >35 years: biliary aetiology was less frequent (23% versus 43%, p=0.003) as well as alcohol-related (8% versus 24%, p=0.01); drug-induced was more common (16% versus 4%, p=0.0007), as well as cannabis-related (13% versus 1%, p<0.0001), or genetic (10% versus 1.5%, p=0.003).
  
  
  CONCLUSIONS
  The aetiologies of acute pancreatitis significantly differed in adults aged less than 35 years when compared to older patients. Thus, use of medications, exposure to cannabis, and genetic mutations should be actively sought in these patients.
authors: Department of Gastroenterology, University Hospital Centre Rangueil-Larrey, University of Toulouse, Toulouse, France.
authors: Adrian
authors: A
authors: Culetto
authors: Department of Gastroenterology, University Hospital Centre Rangueil-Larrey, University of Toulouse, Toulouse, France.
authors: Barbara
authors: B
authors: Bournet
authors: Department of Gastroenterology, University Hospital Centre Rangueil-Larrey, University of Toulouse, Toulouse, France.
authors: Audrey
authors: A
authors: Haennig
authors: Department of Internal Medicine, University Hospital Centre Purpan, University of Toulouse, Toulouse, France.
authors: Laurent
authors: L
authors: Alric
authors: Department of Gastroenterology, University Hospital Centre Purpan, University of Toulouse, Toulouse, France.
authors: Jean-Marie
authors: JM
authors: Peron
authors: Department of Gastroenterology, University Hospital Centre Rangueil-Larrey, University of Toulouse, Toulouse, France. Electronic address: Buscail.L@chu-toulouse.fr.
authors: Louis
authors: L
authors: Buscail
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Acute pancreatitis; Cannabis consumption; Hereditary pancreatitis; Magnetic-resonance cholangiopancreatography