The “I GET SMASHED” Mnemonic
The two most common causes, gallstones and alcohol, account for the majority of cases, but the full mnemonic ensures that rarer—yet serious—causes are not overlooked:
I – Idiopathic: For cases where a clear cause cannot be identified (often a diagnosis of exclusion).
G – Gallstones: The most common cause worldwide, where stones obstruct the ampulla of Vater, blocking the outflow of pancreatic enzymes.
E – Ethanol (Alcohol): The most common cause in many Western countries, often associated with chronic alcohol abuse.
T – Trauma: Blunt abdominal trauma can directly injure the pancreas, leading to enzyme leakage and autodigestion.
S – Steroids: Corticosteroids are a class of drugs known to induce pancreatitis.
M – Mumps: A viral infection (and other infections like Coxsackievirus) that can inflame the pancreas.
A – Autoimmune: Autoimmune pancreatitis is a form of the disease that responds to steroid therapy.
S – Scorpion Sting: Specifically venom from scorpions of the Tityus genus, particularly those found in the Caribbean and South America.
H – Hyperlipidemia/Hypercalcemia: Metabolic disorders, notably severe hypertriglyceridemia (usually >1000 mg/dL) and hypercalcemia (often due to hyperparathyroidism).
E – ERCP (Endoscopic Retrograde Cholangiopancreatography): A common iatrogenic (procedure-related) cause, occurring after manipulation of the pancreatic duct.
D – Drugs: A broad category including medications like azathioprine, sulfonamides, and certain diuretics.
This memorable acronym organizes the most common and critical etiologies of acute pancreatitis, ensuring that clinicians can rapidly consider a comprehensive differential diagnosis.
Dr. Kunal Varma Bheecarry, MD is a GMC registered substantive Consultant Physician in the UK, specializing in Internal Medicine. With more than 15 years of experience on the clinical frontlines in both General Internal Medicine and Acute Medicine, he is passionate about translating complex medical topics, common problems and clinical guidelines into clear, actionable knowledge for healthcare professionals and patients alike. Every article is written and rigorously reviewed by him and other registered medical professionals to ensure clinical accuracy, guideline compliance, evidence-based reliability, authoritativeness and trustworthiness.
Disclaimer: All content is purely educational and does not constitute personal medical advice. It is not a substitute for professional clinical advice and readers must consult their own primary team. All views and interpretations are mine and not related to the work place.