Beyond Alcohol and Gallstones: Uncommon Causes of Pancreatitis

Pancreatitis is a major cause of hospital admissions with significant associated morbidity and mortality. Global incidence rates have continued to increase over the last several decades with United States leading the Western world. The most common causes include gallstones for acute pancreatitis and alcohol abuse for both chronic and acute pancreatitis; these are well described in the literature and not infrequently encountered in the day-to-day practice of radiology. Several uncommon pancreatitis causes have unique characteristic patient demographics, clinical presentations, and imaging findings. The unique features relevant to the practice of radiology are discussed for autoimmune pancreatitis, groove pancreatitis, tropical pancreatitis, hereditary pancreatitis, and pancreatic adenocarcinoma presenting as acute pancreatitis with companion cases. The differentiating features of these uncommon causes are emphasized to arrive at a diagnosis. Should imaging remain equivocal, the next steps necessary to arrive at a diagnosis are reviewed. Understanding the various presentations of acute and chronic pancreatitis, both uncommon and common causes are of utmost importance for the practicing radiologist in facilitating management of patient care.