Table 1.

Causes of AP

Mechanism	Example
Obstructive	•Gallstones or ‘biliary sludge’ •After ERCP •Neoplasm (rare) •Pancreas divisum (controversial) •Sphincter of Oddi (controversial) •Cystic fibrosis
Toxic	•Chronic alcohol excess •Hypertriglyceridaemia •Drugs: immunosuppressants (steroids, azathioprine); diuretics (furosemide, thiazides); oestrogens; sulphonamides; metronidazole •Hypercalcaemia •Hyperparathyroidism •Scorpion or snake bites (rare)
Ischaemia/reperfusion	•Cardiopulmonary bypass •Shock states •Vasculitides
Infection	•Viruses: Cytomegalovirus, mumps, coxsackie B, Epstein-Barr virus •Parasites: Ascaris, Clonorchis
Trauma	•Blunt or penetrating trauma •Surgical
Other	•Hypothermia •Genetic (α1-antitrypsin deficiency) •Autoimmune (sclerosing cholangitis) •Idiopathic
Other associated risk factors	•Diabetes •Obesity •Smoking