Evaluation of previous abdominal pain episodes in women with biliary pancreatitis: possible higher incidence of recurrent attacks.

Background And Aim: Recurrent biliary pancreatitis is described as episodes of new abdominal pain after diagnosis of pancreatitis. Few studies have analyzed the abdominal pain before the diagnosis of acute pancreatitis. Our study aimed to analyze factors associated with previous abdominal pain episodes in patients with biliary pancreatitis, and elucidate its possible pancreatic origin.

Methods: Data from direct interrogation and medical records was analyzed from 48 hospitalized female patients with diagnosis of acute biliary pancreatitis.

Results: Mean age of our patients was 31.6 years (SD +/- 13.9). Forty one (85.4%) patients gave history of at least one previous abdominal pain episode. During the episode 37 (90.2%) patients received H2 receptor antagonist or proton pump inhibitors as treatment; 26 (63.4%) had epigastric pain; 23(56.1%) gave association with cholecystokinetic food; 21 (51.2%) complained of nausea and/or vomiting; 23 (56.1%) had jaundice, acholia and/or dark urine; and 20 (48.9%) patients had microlithiasis and/or biliary sludge.

Conclusions: Previous abdominal pain episodes had similar characteristics to a pancreatic episode in a high percentage of our patients. These characteristics suggest that these episodes are often undiagnosed pancreatic attacks.