Non-alcoholic etiologies of acute pancreatitis - exclusion of other etiologic factors besides alcohol and gallstones.

The etiology of an attack of acute pancreatitis (AP) is highly variable. It is important to identify the causing factor, because it can have an effect on the specific treatment of AP. Furthermore, in some cases relapses of AP can be prevented when the causing factor is eliminated. The most common etiology of AP is alcohol abuse and gallstone disease (>80% of all cases). What diagnostic measures should be undertaken before an attack of AP is considered as idiopathic? Important factor in the etiologic diagnostic work-up is the availability, safety, and cost-effectiveness of suitable methods. Further, the relevance of the findings has to be assessed. In some cases also the age of the patient and number of attacks of AP (first vs. recurring) have effects on efforts to detect the causing factor of AP. This review focuses on the search for other etiologic factors once alcohol and gallstones have been excluded.