Acute pancreatitis in a low alcohol-consuming community.

The case records 50 patients with abdominal pain and hyperamylasemia were studied in detail. Ten cases of gallstone induced hyperamylasemia, in which no evidence of pancreatitis was found at operation, were excluded. The etiological factors in the remaining group of forty cases of acute pancreatitis, in a community practicing alcohol abstinence, were reviewed. Both alcoholic and idiopathic pancreatitis were insignificant factors in the etiology of acute pancreatitis. Eighty percent of cases of acute pancreatitis were due to biliary tract disease. A younger age-group and female preponderance, as well as biochemical evidence of cholestasis, was observed in this group. An inverse relationship between preoperative serum amylase levels and the severity of the disease was noted. A more aggressive diagnostic work-up is, however, warranted to identify these cases, for which early surgery is advocated. There was no mortality in operated cases of biliary pancreatitis.