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 disorde r. In this case-control study, admission ultrasound examinations of pa tients with idiopathic pancreatitis, patients with acute alcohol-assoc iated pancreatitis and a control group were compared. Biliary sludge w as found in seven of 21 patients (33%) with idiopathic pancreatitis, t wo 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 t he 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 pati ents with idiopathic pancreatitis who had sludge identified. This stud y provides further evidence linking biliary sludge with a significant proportion of patients with idiopathic acute pancreatitis.