Changing aetiology of acute pancreatitis.

A retrospective study was undertaken in two groups of patients admitted due to acute pancreatitis in order to obtain information of the relative importance of the main aetiological factors. The first group, consisting of 97 patients, was admitted during 1967--68; the second group of 163 patients during 1977--78. Biliary disease was the main causative factor (53.4%) in the first group of patients with a first-attack of pancreatitis, and alcoholism accounted for only 15.9%. In the second group, ten years later, alcoholism assumed a leading role accounting for 57.5% of the first attack victims as compared to biliary disease with 22.5%. In the total material alcoholism was the aetiological factor in 80.8% of patients with relapsing acute pancreatitis. The absolute and proportional increase of alcohol-induced pancreatitis might be a consequence of a 2.5 fold rise of the consumption of alcohol in Finland during the period of study. Acute alcoholic pancreatitis affected mostly young men and showed a mortality of 7.2% as compared to that of biliary pancreatitis with 13.5% mortality.