Role of Ercp in Idiopathic Pancreatitis

GASTROINTESTINAL ENDOSCOPY S231 Caused primarily by gallstones and alcohol in the adult U.S. population, acute pancreatitis is associated with considerable morbidity. Mortality rates, in turn, have been reported as between 5% and 10% and usually are the consequence of sepsis or multiorgan failure.1-4 ERCP interaction in acute pancreatitis has primarily been one of cause and effect.5 In other words, there is a variable incidence of acute pancreatitis after the performance of ERCP, particularly when studying patients with presumed sphincter of Oddi dysfunction. Procedure-related pancreatitis is thought to be the consequence of sphincter edema or spasm, rupture of small ductules or pancreatic acini, or may be due to the direct toxicity of the contrast agent used. Because it is a homeopathic tenet that “like cures like,” deep-seated homeopathic insecurities may be involved when practitioners attempt to treat acute pancreatitis with ERCP, one of its major etiologies.