IS INTERVENTION NECESSARY AFTER A FIRST EPISODE OF ACUTE IDIOPATHIC PANCREATITIS

Acute idiopathic pancreatitis is a term used when no underlying cause has been identified on routine investigation. However, more specialise d investigations may identify aetiological factors, biliary sludge and sphincter of Oddi dysfunction for example, in 38-72% of patients with recurrent episodes. Treatment of these abnormalities may prevent furt her episodes of pancreatitis. The aim of this study was to follow up a nd determine the outcome in patients with a first episode of idiopathi c pancreatitis, and thus determine the need for further investigation and treatment in this group of patients. Thirty one patients with a si ngle episode of idiopathic pancreatitis were studied who had no specia lised investigations or specific treatment. During a median follow up of 36 months only one patient has had recurrent pancreatitis. Two pati ents experienced a single episode of unexplained abdominal pain; serum amylase, liver biochemistry, and abdominal ultrasound were all normal and the pain resolved within 48 hours. In conclusion, in the medium t erm, the prognosis is good after a first episode of idiopathic pancrea titis and specialised investigation is unnecessary.