Etiology of acute pancreatitis in Northeastern India, Sikkim

Background: Acute pancreatitis (AP) is an inflammatory disorder of the pancreas with diverse underlying causes that vary according to regional, demographic, and lifestyle-related factors. Limited epidemiological data are available from the Northeastern Himalayan belt of India. This study was undertaken to explore the causative factors of AP in patients admitted to a tertiary healthcare facility in Sikkim. Methods: This prospective, hospital-based study was carried out over one year (February 2023 to January 2024) in the Department of Gastroenterology at Sir Thutop Namgyal Memorial Multispeciality Hospital, Sikkim. Fifty-one patients with a clinical diagnosis of AP, meeting the revised Atlanta criteria were included. Relevant clinical profiles, laboratory investigations, and imaging findings were analyzed to establish underlying etiologies. Results: Of the 51 enrolled patients, two-thirds (66.7%) were male. The average age at diagnosis was 41.6 years. Alcohol consumption emerged as the leading cause (45.1%), followed by gallstone disease (31.4%). Other etiologies included idiopathic (11.8%), hypertriglyceridemia-related (7.8%), and drug-induced pancreatitis (3.9%). Males were predominantly affected by alcohol-related AP, whereas gallstone pancreatitis was more frequently seen in females. Most patients reported abdominal pain and vomiting as presenting complaints. The clinical course was relatively benign, with no mortality recorded. Conclusions: Alcohol use and gallstones were the primary contributors to AP in this regional population, with clear gender-related trends. These results highlight the importance of developing targeted, locally relevant prevention strategies.