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Alcoholic Pancreatitis — RACP Adult Medicine MCQ

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EasyGastroenterologyAlcoholic PancreatitisRACP Adult Medicine

A 40-year-old man presents with severe acute pancreatitis. He has a history of drinking 80 g alcohol daily for 15 years. Lipase is 4500 U/L. Ultrasound shows no gallstones. LFTs are mildly elevated (ALT 55, GGT 280). Triglycerides and calcium are normal. What is the most likely aetiology?

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Correct answer: A — Alcohol-related pancreatitis

Acute pancreatitis with no gallstones, heavy chronic alcohol use (>80 g/day for >5 years), and elevated GGT (marker of chronic alcohol use) is alcohol-related acute pancreatitis. It is the second most common cause after gallstones. Alcohol causes pancreatitis through direct toxic effects on acinar cells and pancreatic duct obstruction. Management: supportive care, analgesia, early enteral nutrition. Alcohol abstinence is essential to prevent recurrence and progression to chronic pancreatitis.

Reference: GESA – 2024 – Acute Pancreatitis; eTG GI 2024