<prompt> Commonest cause of acute pancreatitis is:AlcoholGail stonesVirusesHypertrigyceridemia  <response>: Gall stone: Ref: 1122-LB, 1896-H 1139-B L 25thACUTE PANCREATITIS Gallstone Continues to be the leading cause of acute pancreatitis in most series 30 - 60 Alcohol is the second most common cause 15 - 30. Hypertriglyceridemia 1.3 - 3.8 ERCP 5 - 20 Drug induced 2 - 5Clinical features - Pain is the cardinal symptoms The patient usually a middle-aged person, presents with severe pain illimitable agency in the epigastrium of sudden onset radiating to the back. The attack usually follows a heavy meal or a bout of alcohol drinking and may be associated with vomiting and hypotension The abdomen may be rigid and distended with a hyper-resonant note. There may be tenderness in the epigastrium and in left renal angle The patient may have a tinge of jaundice There may be discolouration of the skin of the loin Grey-Turnors sign. The skin around umbilicus may be discoloured Cullens sign A tender ill defined lump may be felt in the upper abdomenTowards the end of the second week of attack it is usually a pseudo cyst and towards the end of third or fourth week it is usually a pancreatic abscess. 