Ansa pancreatica as a predisposing factor for recurrent acute pancreatitis

Table 1 Characteristics of subjects in the community group with and without ansa pancreatica

	All subjects (n = 587)	Subjects without ansa pancreatica (n = 582)	Subjects with ansa pancreatica (n = 5)	P value	OR (95%CI)
Age (yr)	56.8 ± 10.4	56.8 ± 10.4	53.6 ± 10.7	0.601
Females	250 (43)	248 (43)	2 (40)	0.702
Brinkman index (cigarettes/d × years)	244 ± 408	246 ± 409	120 ± 240	0.361
Alcohol intake (kg/yr)	5.8 ± 7.8	5.7 ± 7.7	11.4 ± 12.9	0.431
Clinical history
All cases of pancreatitis3	6 (1)	5 (0.9)	1 (20)	0.0502	28 (0.49-364)
Acute pancreatitis	4 (0.7)	3 (0.5)	1 (20)	0.0342	46 (0.74-746)
Diabetes mellitus	30 (5)	30 (5)	0	12
Hypertension	109 (19)	109 (19)	0	0.592
Hyperlipidemia	67 (11)	67 (12)	0	12
Any malignant neoplasm	45 (8)	45 (8)	0	12
Autoimmune disease	14 (2)	14 (2)	0	12

Values are presented as the n (%) or mean ± SD deviation.

¹Welch’s t test;

²Fisher’s exact test;

³Includes subjects with single-episode acute pancreatitis and subjects with recurrent acute pancreatitis.

Table 2 Characteristics of patients with single-episode acute pancreatitis with and without ansa pancreatica

	All patients (n = 55)	Patients without ansa pancreatica (n = 54)	Patients with ansa pancreatica (n = 1)
Age (yr)	57.5 ± 18.5	57.6 ± 18.5	50
Females	16 (29)	16 (30)	0 (0)
Brinkman index (cigarettes/d × years)	355 ± 887	364 ± 888	0
Alcohol intake (kg/yr)	8.1 ± 11.1	7.9 ± 11.1	16.1
Clinical history
Diabetes mellitus	11 (20)	11 (22)	0 (0)
Hypertension	14 (25)	14 (29)	0 (0)
Hyperlipidemia	12 (22)	12 (25)	0 (0)
Any malignant neoplasm	8 (15)	8 (16)	0 (0)
Autoimmune disease	5 (9)	5 (10)	0 (0)

Values are presented as the n (%) or mean ± SD.

Table 3 Characteristics of subjects with recurrent acute pancreatitis with and without ansa pancreatica

	All patients (n = 18)	Patients without ansa pancreatica (n = 16)	Patients with ansa pancreatica (n = 2)	P value
Age (yr)	46.1 ± 14.4	44.6 ± 14.1	58.5 ± 9.5	0.361
Female	9 (50)	8 (50)	1 (50)	12
Brinkman index (cigarettes/d × years)	103.1 ± 174	122 ± 183	0 ± 0	0.061
Alcohol intake (kg/yr)	1.06 ± 2.01	1.14 ± 2.1	0	0.621
Clinical history
Diabetes mellitus	1 (6)	0 (0)	1 (50)	0.192
Hypertension	3 (17)	3 (19)	0 (0)	112
Hyperlipidemia	5 (28)	5 (31)	0 (0)	11
Any malignant neoplasm	0 (0)	0 (0)	0 (0)	11
Autoimmune disease	4 (22)	4 (25)	0 (0)	11

Values are presented as the n (%) or mean ± SD.

¹Welch’s t test;

²Fisher’s exact test.

Table 4 Causes of pancreatitis and ansa pancreatica

Cause	All patients with acute pancreatitis (n = 73)	Patients with single-episode acute pancreatitis (n = 55)	Patients with recurrent acute pancreatitis (n = 18)
Gallstones	19 (26.0)	18 (33.0)	1 (5.6)
Alcohol	14 (19.0)[2]	12 (22.0)[1]	2 (11.0)[1]
Idiopathic	10 (14.0)[1]	6 (11.0)	4 (22.0)[1]
Iatrogenic	6 (8.2)	6 (11.0)	0 (0)
Pancreas divisum1	6 (8.2)	1 (1.8)	5 (28.0)
Autoimmunity2	4 (5.6)	2 (3.6)	2 (5.6)
Meandering main pancreatic duct3	3 (4.2)	1 (1.8)	2 (11.0)
Pancreaticobiliary maljunction	1 (1.4)	1 (1.8)	0 (0)
Alcohol and hyperlipidemia combined	1 (1.4)	1 (1.8)	0 (0)
Choledocal cyst, pancreaticobiliary maljunction, and pancreas divisum combined	1 (1.4)	1 (1.8)	0 (0)
Cholesterol embolism	1 (1.4)	1 (1.8)	0 (0)
Crohn’s disease	1 (1.4)	1 (1.8)	0 (0)
Drug induced	1 (1.4)	1 (1.8)	0 (0)
Hyperlipidemia	3 (4.2)	2 (3.6)	1 (5.6)
Hypothermia	1 (1.4)	1 (1.8)	0 (0)
Sphincter of Oddi dysfunction	1 (1.4)	0 (0)	1 (5.6)

Values are presented as the n (%); values in square brackets represent the number of subjects with ansa pancreatica.

¹Diagnosed according to the criteria used in a previous study[8];

²Diagnosed according to the Asian Criteria of Autoimmune Pancreatitis revised in 2008[27];

³Diagnosed according to the criteria used in a previous study[9].

Table 5 Frequency of ansa pancreatica and its association with single-episode and recurrent acute pancreatitis

	Cases of ansa pancreatica (%)	P value1	OR (95%CI)
All patients with acute pancreatitis	3/73 (4.1)	0.048	4.97 (0.76-26.2)
Patients with single- episode acute pancreatitis	1/55 (1.8)	0.42	2.12 (0.04-19.7)
Patients with recurrent acute pancreatitis	2/18 (11.1)	0.0162	14.3 (1.27-96.1)
Community group	5/587 (0.85)

¹Fisher’s exact test for comparisons with the community group;

²Statistically significant after family-wise correction.

Table 6 Comparison of the characteristics of patients with recurrent acute pancreatitis and the community group

	Community group (n = 587)	Patients with recurrent acute pancreatitis (n = 18)	P value	OR (95%CI)
Age (yr)	56.8 ± 10.4	46.1 ± 14.4	0.000112
Female	250 (43)	9 (50)	0.633
Brinkman index (cigarettes/d × years)	244 ± 408	103.1 ± 174	0.0191
Alcohol intake (kg/yr)	5.8 ± 7.8	1.06 ± 2.0	< 0.000112
Clinical history
Diabetes mellitus	30 (5)	1 (6)	13
Hypertension	109 (19)	3 (17)	13
Hyperlipidemia	67 (11)	5 (28)	0.0513
Any malignant neoplasm	45 (8)	0 (0)	0.393
Autoimmune disease	14 (2)	4 (22)	0.001023	11.6 (2.46-43.7)

Values are presented as the n (%) or mean ± SD.

¹Welch’s t test;

²Statistically significant after family-wise correction;

³Fisher’s exact test.