The etiological factors in 73 cases of acute pancreatitis.

Seventy-three cases of acute pancreatitis were studed in detail to determine the pattern and etiology in an alcohol free community. The majority of cases were found to be of the interstitial edematous type. For religious, cultural and legal reasons there were no true alcoholic cases. Over half (38) were of biliary origin. The remaining 35, at first described as "idiopathic" on admission, were carefully studied for the possible etiological factors. It was found that eight were attributable to steroids, 15 to estrogens and nine to tetracyclines and only three cases were described as "idiopathic". The criteria and reasons for their identification are reviewed. The author recommends careful study and monitoring of all cases termed idiopathic, as well as a high index of suspicion in patients receiving steroids, estrogens or tetracyclines, if they develop abdominal pain. It is advisable to avoid estrogens in cases of hyperlipidemia. The term iatrogenic pancreatitis should be applied to these cases.