Etiology of acute pancreatitis in a tertiary care teaching hospital.

Objective: To determine the frequency of etiological factors of acute pancreatitis at a tertiary care hospital, and their association, particularly gallstone disease, with demographic/clinical characteristics. Study Design: Descriptive, Prospective Observational study. Setting: General Surgery, MTI–Lady Reading Hospital, Peshawar. Period: Six Months (1st July–31st December 2025). Methods: Patients aged 30–70 with abdominal pain plus amylase >300 U/L and lipase >480 U/L were enrolled after consent, differing from the Revised Atlanta Classification; duct dilation, pseudocyst, bleeding disorders, and end-stage renal/liver disease were excluded. Gallstones, idiopathic disease, autoimmune disease, dyslipidaemia, and smoking were assessed (alcohol excluded); gallstone etiology was compared by Chi-square/Fisher's exact test (p<0.05). Results: Of 140 screened, 101 met the case definition (mean age 45.75±9.03 years; 54, 53.5% female). Gallstone disease was leading (54, 53.5%, 95% CI 43.8–62.9%; 61, 60.4% overall), followed by idiopathic disease (16, 15.8%), smoking alone (10, 9.9%), dyslipidaemia (16, 15.8%), autoimmune disease (2, 2.0%), and multiple factors (12, 11.9%); no significant demographic/clinical association emerged. Conclusion: Gallstone disease was commonest, followed by idiopathic disease, smoking, and dyslipidaemia. As the case definition differs from the Revised Atlanta Classification and alcohol history was unrecorded, findings warrant cautious interpretation.