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TIGAR-0 Classification of Risk Factors and Etiologies of Chronic Pancreatitis
TIGAR-O Classification System (Version 1.0).
From Etemad & Whitcomb Gastroenterology 2001; 120(3):682-707

Toxic-Metabolic

• Alcoholic
• obacco smoking
• Hypercalcemia
• Hyperparathyroidism
• Hyperlipidemia
• Chronic Renal Failure
• Medications
• Phenacetin abuse (possibly from to chronic renal insufficiency)
• Toxins
• Organotin compounds (e.g. di-n-butyltin dichloride (DBTC))

Idiopathic

• Early onset
• Late onset
• Tropical
• Tropical calcific pancreatitis
• Fibrocalculous pancreatic diabetes
• Other

Genetic

• Autosomal Dominant
  • Cationic trypsinogen (Codon 29 and 122 mutations)
• Autosomal Recessive/modifier genes
• CFTR mutations
• SPINK1 Mutations
• Cationic trypsinogen (Codon A16V, D22G, K23R)
• Alpha 1 -antitrypsin deficiency (possible)

Autoimmune

• Isolated Autoimmune Chronic Pancreatitis
• Syndromic Autoimmune Chronic Pancreatitis
  • Sj~grens syndrome associated chronic pancreatitis
  • Inflammatory bowel disease associated chronic pancreatitis
  • Primary Biliary Cirrhosis associated chronic pancreatitis

Recurrent and Severe Acute Pancreatitis Associated Chronic Pancreatitis

• Postnecrotic (severe acute pancreatitis)
• Recurrent acute pancreatitis
• Vascular Diseases / ischemic
• Postirradiation

Obstructive

• Pancreatic Divisum
• Sphincter of Oddi disorders (controversial)
• Duct obstruction (e.g. tumor)
• Preampullary duodenal wall cysts
• Posttraumatic pancreatic duct scars

DISCLAIMER: This information is designed as a tool for background for pancreatic disorders and is not designed to serve as sole medical advice or meant to replace a full medical evaluation. Please consult your personal physician for additional information before making any changes to your diet, lifestyle, or medical treatment.

Updated March 28, 2005

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