The Extent of the Problems and the Epidemiological Aspects of Alcohol Drinking
Victor R. Preedy, Ronald R. Watson in Alcohol and the Gastrointestinal Tract, 2017
Pancreatitis has long been associated with excessive alcohol drinking, evidenced mainly on the basis of clinical observations. Because of the relatively low frequency of the disease, epidemiological evidence has been rather limited. In a follow-up study of alcoholics who were U.S. veterans, there were six deaths from benign pancreatic diseases, compared with one in the comparison group, giving a relative risk of 6.6.33 Alcoholics also had a significantly higher rate of hospitalization for pancreatic diseases than controls in another study.50 In two other followup studies of Swedish conscripts and a random sample from the male general population in Finland, pancreatitis was analyzed combined with liver cirrhosis. In the Swedish study, the relative risk for liver cirrhosis and pancreatitis combined was 11.0 for men who consumed 250 g or more alcohol per week as compared with men who consumed 100 g or less alcohol per week.29 In the Finnish study, the consumption of at least five bottles of beer per week yielded a relative risk of 3.7 for deaths due to liver cirrhosis and acute pancreatitis combined.96 Neither of these studies reported how many pancreatitis cases were included. Yen et al. conducted a case-control study at 11 hospitals in eastern Massachusetts. They confirmed that alcohol was an independent risk factor for pancreatitis in men, providing a relative risk of 2.2 for regular drinkers,97 Another case-control study in France also found that the alcohol intake per day was directly associated with the risk of chronic pancreatitis.98
Gastrointestinal and Genitourinary Imaging
Gareth Lewis, Hiten Patel, Sachin Modi, Shahid Hussain in On Call Radiology, 2015
Symptoms and signs of acute pancreatitis include abdominal pain, nausea and vomiting and pyrexia. If severe, a profound systemic inflammatory response can lead to haemodynamic instability and, ultimately, multiorgan failure. The diagnosis is often suggested by a significant elevation in serum pancreatic enzyme levels (e.g. amylase and lipase), although a low level elevation of amylase is non-specific and can also be seen in other causes of an acute abdomen. Many clinical scoring systems, such as the Glasgow (Table 2.17) and APACHE II (Acute Physiology and Chronic Health Evaluation) Scores are used to provide an objective assessment of the severity of pancreatitis. Complications of acute pancreatitis include pancreatic pseudocysts, focal abscess formation and peripancreatic fluid collections, pancreatic necrosis, haemorrhage, arterial pseudoaneurysm formation and venous thrombosis (e.g. the portal and splenic veins).
Management of Diabetes in Developing Countries
Emmanuel Opara in NUTRITION and DIABETES, 2005
With regards to the investigations to be undertaken, coexisting disease that may precipitate ketosis (especially infectious diseases) should always be ruled out. In children and young adults, screening for beta-cell autoimmunity (antiGAD) permits the identification of true type 1 diabetes patients that may require lifetime insulin-replacement therapy. Pancreatic imaging (abdominal ultrasound or plain X-ray) to rule out possible chronic pancreatitis is of interest in patients with signs of undernutrition or history of heavy alcohol consumption. C-peptide measurements after stimulation by IV glucagon are predictive of further remission and might be of interest. However, in routine practice, recurrent hypoglycemia and rapid normalization of HbA1c levels despite reduction of exogenous insulin dose is the best marker of possible remission (45).
Logistic regression analysis of risk factors for hemorrhagic fever with renal syndrome complicated with acute pancreatitis
Published in Annals of Medicine, 2023
Wenjie Wang, Dongqing Fan, Bin Quan, Weishun Hou, Jinsun Yang
The results of the multivariate analysis in this study showed that HFRS patients with an alcohol consumption history were more likely to have AP than patients without an alcohol consumption history, and an alcohol consumption history may be a risk factor. Alcohol consumption predisposes patients to various infections (including bacterial infections and viral infections) [21,22]. Epidemiological data have established that excessive alcohol consumption is the second leading cause of AP after gallstones [11] and the most prevalent risk factor for CP [23]. It is also a risk factor for recurrent pancreatitis after the first AP attack and increases the risk of progression to CP [24]. Alcohol exposure contributes to the initiation and progression of pancreatitis. However, how alcohol consumption predisposes the pancreas to disease is not entirely understood. Additionally, several studies have shown that the risk of getting AP is higher if the patient is a current or an ex-smoker compared with nonsmokers [25,26], but our study did not find that smoke is a risk factor of HFRS complicated with AP.
The effect of intravenous insulin, apheresis and oral lipid-lowering agents on non-fasting hypertriglyceridemia and associated pancreatitis
Published in Postgraduate Medicine, 2018
Daniela Frankova, Kristin Melissa Olson, Brian Joseph Whyms, Maria Alejandra Guevara Hernandez, Jan Franko
Pancreatitis was present among 45% of patients with initial triglycerides ≥1000 mg/dl. A majority of the pancreatitis patients reported alcohol use, a known risk factor for developing pancreatitis. Interestingly, alcohol use has also been noted to contribute to serum triglyceride increase in prior studies [15], a finding confirmed in the present study. Although alcohol use was reported in most of our studied patients who developed pancreatitis, a case series of 129 patients referred to an endocrinology center in Paris, France found no significance in the risk factors of alcohol use, sex, smoking history, body mass index, or history of diabetes mellitus contributing to the development of acute pancreatitis in patients with hypertriglyceridemia [3].
Endoscopic ultrasound-guided pancreatic fluid collections' transmural drainage outcomes in 100 consecutive cases of pseudocysts and walled off necrosis: a single-centre experience from the United Kingdom
Published in Scandinavian Journal of Gastroenterology, 2018
Chander Shekhar, Ben Maher, Colm Forde, Brinder Singh Mahon
In our cohort, 59 men and 41 women with median age 56 (47.5–66.0) years underwent EUS-guided drainage. In these 100 sequential cases, there were 78 cases of PP and 22 cases of WON. The most common attributed aetiologies of pancreatitis were excess alcohol consumption (38) and gallstones (26). Other less common causes included post-pancreatic surgery (9), trauma (3), chemotherapy (3) and unknown cause (21). Eleven patients had acute on chronic pancreatitis of which seven were deemed PP and four deemed WON. Of these total 11 patients with acute on chronic pancreatitis, eight patients were related to alcohol and three were of unknown aetiology.