20 | P a g e
K N O W M E D G E
The prevalence of pancreatitis continues to rise in the Western world, and thus remains
a favorite for the ABIM boards. Although alcohol and gallstones remain the major cause
of acute pancreatitis, metabolic (hyperlipidemia, hypercalcemia), infectious (CMV,
EBV, parasites), and autoimmune causes should be considered.
Remember:
Diagnosis of acute pancreatitis can be made without imaging, but
contrast-enhanced CT scan is used if there is concern for necrotizing
pancreatitis
If necrotizing pancreatitis is suspected, prophylactic antibiotics should be
used – imipenem, cephalosporins, and fluoroquinolones
ERCP is used if there is evidence of gallstone pancreatitis and suspected
biliary obstruction
Consider a deficiency in fat-soluble vitamins (A, D, E, K) in chronic
pancreatitis
Look for CA 19-9 as a tumor marker for pancreatic cancer. Better yet, be able to
recognize the whole table of important tumor markers discussed in the oncology section
of Knowmedge.