Idiopathic acute recurrent pancreatitis

Acute recurrent pancreatitis (ARP) results most commonly from alcohol abuse or gallstone disease. Initial evaluation fails to detect the cause of ARP in 10-30% of patients, and as a result the diagnosis of "idiopathic" ARP is given. In these patients, a more extensive evaluation including specialize d labs, ERCP, endoscopic ultrasound, or magnetic resonance cholangiopancrea tography typically leads to a diagnosis of inicrolithiasis, sphincter of Od di dysfunction, or pancreas divisum. Less commonly, hereditary pancreatitis , cystic fibrosis, a choledochocele, annular pancreas, an anomalous pancrea tobiliary junction, pancreatobiliary tumors, or chronic pancreatitis are di agnosed. Determining the etiology is important, as it helps to direct thera py, limits further unnecessary evaluation, and may improve a patient's long term prognosis. (Am J Gastroenterol 2001;96: 2540-2555. (C) 2001 by Am. Co ll. of Gastroenterology).