Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Nov 15, 2015; 6(4): 243-248
Published online Nov 15, 2015. doi: 10.4291/wjgp.v6.i4.243
Energetic etiologies of acute pancreatitis: A report of five cases
Artem Shmelev, Alain Abdo, Sarina Sachdev, Urvi Shah, Gopal C Kowdley, Steven C Cunningham
Artem Shmelev, Alain Abdo, Sarina Sachdev, Urvi Shah, Gopal C Kowdley, Steven C Cunningham, The Department of Surgery, Saint Agnes Hospital, Baltimore, MD 21229, United States
Author contributions: Shmelev A and Abdo A contributed equally to this work; Shmelev A, Abdo A, Sachdev S, Shah U, Kowdley GC and Cunningham SC participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Kowdley GC and Cunningham SC were the guarantors and designed the study; Shmelev A, Abdo A, Sachdeva S, Shah U, Kowdley GC and Cunningham SC revised the article critically for important intellectual content.
Institutional review board statement: Study of the acute pancreatitis patients was approved by SAH-IRB 2011-030.
Informed consent statement: Need for consent was waived by SAH-IRB 2011-030. There are no details that might identify the patients in this manuscript.
Conflict-of-interest statement: None of the authors have any conflict of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Steven C Cunningham, MD, FACS, Director of Pancreatic and Hepatobiliary Surgery and Research, The Department of Surgery, Saint Agnes Hospital, 900 Caton Avenue, MB 207, Baltimore, MD 21229, United States. steven.cunningham@stagnes.org
Telephone: +1-443-8146773 Fax: +1-410-7190094
Received: March 26, 2015
Peer-review started: March 28, 2015
First decision: August 20, 2015
Revised: September 15, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: November 15, 2015
Processing time: 235 Days and 23.1 Hours
Abstract

There are several common causes of acute pancreatitis, principally excessive alcohol intake and gallstones, and there are many rare causes. However, cases of pancreatitis still occur in the absence of any recognizable factors, and these cases of idiopathic pancreatitis suggest the presence of unrecognized etiologies. Five cases of acute pancreatitis in four patients came to attention due to a strong temporal association with exposure to nerve stimulators and energy drinks. Given that these cases of pancreatitis were otherwise unexplained, and given that these exposures were not clearly known to be associated with pancreatitis, we performed a search for precedent cases and for mechanistic bases. No clear precedent cases were found in PubMed and only scant, weak precedent cases were found in public-health databases. However, there was a coherent body of intriguing literature in support of a mechanistic basis for these exposures playing a role in the etiology of pancreatitis.

Keywords: Pancreatitis; Energy drinks; Transcutaneous electric nerve stimulation; Etiology; Chronic pain

Core tip: This may be the first report of nerve stimulators or energy drinks playing an etiologic role in the development of pancreatitis. Five recent cases of otherwise unexplained pancreatitis recently came to attention due to a strong temporal association between pancreatitis and exposure to nerve stimulators (3 cases in 3 patients) and energy drinks (2 cases in 1 patient). Although causality is not shown, the temporal association is striking.