Table 1

 Investigations helpful to determine the cause of acute pancreatitis

*Genetic analysis is only indicated in the presence of a family history of one or more of the following: acute pancreatitis, recurrent undiagnosed abdominal pain, pancreatic carcinoma, or type 1 diabetes mellitus.
MRCP, magnetic resonance cholangiopancreatography; ERCP, endoscopic retrograde cholangiopancreatography.
Modified from the World Association guidelines.3
HistoryPrevious gall stones
Alcohol intake
Family history*
Drug intake
Exposure to known viral causes or prodromal symptoms
Initial investigations (acute phase)Pancreatic enzymes in plasma
Liver function tests
Ultrasound of gall bladder
Follow up investigations (recovery phase)Fasting plasma lipids
Fasting plasma calcium
Viral antibody titres
Repeat biliary ultrasound
MRCP
CT (helical or multislice with pancreas protocol)
Further investigations (usually appropriate for recurrent idiopathic acute pancreatitis)Further ultrasound
Endoscopic ultrasound
Autoimmune markers
ERCP—bile for crystals-bile and pancreatic cytology
ERCP—bile and pancreatic cytology
Sphincter of Oddi manometry
Pancreatic function tests to exclude chronic pancreatitis