The differential diagnosis between biliary and alcoholic pancreatitis.

The presenting clinical details of 53 patients admitted with proven primary acute pancreatitis due to gall stones were compared with those of 31 patients in whom the disease was due to other causes. Ten statistically significant differences existed between the two groups (p less than 0.05). A computer data base for each group of patients was prepared by listing the relative frequency of symptoms and signs. A computer program was written to predict the likelihood of gall stones in patients suffering from acute pancreatitis and prediction was correct in 92% of patients. A predictive index devised from the presence of three of the significantly differing clinical features correctly identified gall stones in 82%. Subsequent computer analysis of the presenting clinical symptoms and signs on admission every patient with acute pancreatitis has confirmed the accuracy of this technique and has resulted in alteration in the management whereby cholecystectomy for biliary pancreatitis is performed at an early stage of the illness.