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I GET SMASHED

acrostic

/ˌaɪ ɡɛt ˈsmæʃt/

Gastroenterology

Definition

1.The causes of acute pancreatitis.

Expansion

  1. IIdiopathic no cause found in 10–20% of cases
  2. GGallstones the single most common cause
  3. EEthanol chronic alcohol use — the second most common
  4. TTrauma blunt abdominal injury or post-operative
  5. SSteroids corticosteroid therapy
  6. MMumps and other infections (Coxsackie, EBV)
  7. AAutoimmune e.g. SLE, IgG4-related disease
  8. SScorpion sting classically the Trinidadian Tityus trinitatis
  9. HHypercalcaemia also hypertriglyceridaemia
  10. EERCP a recognised iatrogenic cause
  11. DDrugs azathioprine, valproate, thiazides, oestrogens

Notes

Acute pancreatitis presents with severe epigastric pain radiating to the back, vomiting, and a raised serum amylase or lipase (lipase is more specific). In practice, gallstones and ethanol account for the large majority of cases — the rest of the list earns its keep on exam day.

Severity is graded with scores such as the Glasgow–Imrie or Ranson criteria; watch for the systemic complications of SIRS, hypocalcaemia and necrosis.

Origin

A bartender's lament that doubles as the eleven causes of acute pancreatitis.

See also

  • SOCRATES The framework for taking a pain history.