A 47 year old man presents to the emergency room with sudden onset of severe upper abdominal pain with vomiting. The pain is focused in the epigastrium with radiation to the back. Serum amylase levels are 2000 U/L. Which of the following are the most commonly encountered predisposing factors for this patient's condition?

The clinical scenario is typical of acute pancreatitis. The overwhelmingly most impoant contributing factors for development of acute pancreatitis are gallstones (paicularly small ones) and alcohol abuse. Helicobacter pylori infection and excess gastric acid secretion are predisposing factors for peptic ulcer disease of the stomach and duodenum, respectively. Hepatitis B infection and iron overload predispose for cirrhosis. Predisposing factors for myocardial infarction include obesity, high serum cholesterol, stress, and cigarette smoking. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 15. Pathology of the Liver, Gallbladder, and Pancreas. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.