Pancreatitis Differential Diagnosis

The differential diagnosis for pancreatitis can be organized into the following categories:

• Single Most Likely Diagnosis
  • Acute pancreatitis due to gallstones: This is the most common cause of acute pancreatitis, especially in women, and is often associated with abdominal pain, elevated pancreatic enzymes, and evidence of gallstones on imaging.
• Other Likely Diagnoses
  • Alcoholic pancreatitis: A common cause of chronic pancreatitis, often associated with a history of heavy alcohol use, abdominal pain, and pancreatic calcifications on imaging.
  • Hypertriglyceridemia-induced pancreatitis: Elevated triglyceride levels can cause acute pancreatitis, often in the setting of other risk factors such as diabetes or obesity.
  • Post-ERCP pancreatitis: A known complication of endoscopic retrograde cholangiopancreatography (ERCP), often presenting with abdominal pain and elevated pancreatic enzymes after the procedure.
• Do Not Miss Diagnoses
  • Peptic ulcer disease: While not a direct cause of pancreatitis, peptic ulcers can perforate and cause chemical peritonitis, which may mimic pancreatitis.
  • Intestinal obstruction or infarction: These conditions can cause abdominal pain and elevated pancreatic enzymes, mimicking pancreatitis, and require prompt diagnosis and treatment.
  • Ectopic pregnancy: A life-threatening condition that can cause abdominal pain and may be mistaken for pancreatitis in women of childbearing age.
• Rare Diagnoses
  • Pancreatic divisum: A congenital anomaly of the pancreatic ducts that can cause recurrent pancreatitis.
  • Autoimmune pancreatitis: A rare form of chronic pancreatitis characterized by autoimmune destruction of the pancreas.
  • Tropical pancreatitis: A rare form of chronic pancreatitis seen in tropical regions, often associated with malnutrition and other risk factors.