Korean J Med.  2015 Apr;88(4):387-392. 10.3904/kjm.2015.88.4.387.

Diagnostic Approach to Recurrent Idiopathic Pancreatitis

  • 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. swcha@schmc.ac.kr


Acute recurrent pancreatitis (ARP) most commonly results from alcohol abuse or gallstone disease. Nevertheless, the initial evaluation fails to detect the cause of ARP in 20% to 30% of patients, who are thus diagnosed with idiopathic pancreatitis. Further evaluation is indicated in patients with a severe initial attack of acute pancreatitis or those with two or more attacks. This evaluation might include one or more of the following procedures: specialized laboratory studies, endoscopic ultrasonography (EUS), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP). Based on our experience, the initial step in this evaluation should be MRCP or EUS because of the high safety and diagnostic yield of these techniques. If MRCP or EUS is negative, then ERCP with sphincter of Oddi manometry, intraductal ultrasonography (IDUS), or bile analysis should be considered.


Recurrent; Idiopathic; Pancreatitis; Diagnosis
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