The presence of fecal-like vomit is a clinical symptom of acute pancreatitis. Acute pancreatitis (acutepancreatitis, AP) is a relatively common type of acute abdomen, and its incidence accounts for the third to fifth highest incidence of acute abdomen. More than 80% of these patients have a mild condition, namely acute edematous pancreatitis, which can be cured non-operatively and is basically an internal disease. What is the main etiology of the appearance of fecal-like vomit? There are many causes of acute pancreatitis, and there are regional differences. In China, more than half of them are caused by biliary tract diseases, and in Western countries, alcoholism is also the main cause, in addition to gallstone disease. 1, biliary system diseases Under normal circumstances, the common bile duct and pancreatic duct together open in the Vater’s jugular 80% of the convergence into the duodenum, this common duct is about 2-5mm long, in this common channel or Oddis sphincter at the stone, biliary roundworm or inflammation, edema or spasm caused by obstruction, gallbladder contraction, bile duct pressure exceeds the pressure in the pancreatic duct, bile can be refluxed to the pancreatic The commonducttheory is that 50% of acute pancreatitis is caused by this, especially bile duct stones are the most common; if gallstones move during the process of injury to the common bile duct, jugular abdomen or bile duct inflammation causes dysfunction of the sphincter of Oddis, such as with high pressure in the duodenal cavity, resulting in the reflux of duodenal fluid into the pancreatic duct. The activation of pancreatic enzymes produces acute pancreatitis; in addition, when the biliary tract is inflamed, the release of kinins from bacterial toxins can activate pancreatic digestive enzymes through the traffic branches of the biliopancreatic interstitial lymphatics causing acute pancreatitis. 2, alcohol or drugs In Europe and the United States alcohol abuse is one of the important causes of acute pancreatitis, and in recent years there has been an increasing trend in China. Alcohol can stimulate the secretion of gastrin from the G-cells in the gastric sinus, which increases gastric acid secretion and decreases the pH in the duodenum, making the secretion of pancreatic secretion strong and increasing pancreatic exocrine secretion; long-term alcohol abuse can stimulate the increase of protein content in the pancreatic juice, forming protein emboli to block the pancreatic duct; at the same time, alcohol can stimulate the duodenal mucosa to make the papilla edema, preventing the discharge of pancreatic juice, the cause of which is consistent with the obstruction-secretion strong theory. Some drugs and poisons can directly damage the pancreatic tissue, or promote exocrine pancreatic fluid hypersecretion, or promote pancreatic duct epithelial cell proliferation, alveolar expansion, fibrous changes or cause increased lipids, or promote the Oddis sphincter spasm and cause acute pancreatitis, such as azathioprine, adrenal corticosteroids, tetracycline, thiazide diuretics, L-asparaginase, organophosphorus insecticides. 3, infection Many infectious diseases can be complicated by acute pancreatitis, the symptoms are not obvious, the original disease healed, pancreatitis subsided on its own, the common ones are mumps, viral hepatitis, infectious mononucleosis, typhoid, sepsis, etc. Ascaris entering the bile duct or pancreatic duct can bring in not only intestinal fluid, but also bacteria, which can activate pancreatic enzymes causing inflammation. 4, hyperlipidemia and hypercalcemia Familial hyperlipidemia patients have a significantly higher chance of combined acute pancreatitis than normal people. In hyperlipidemia, fat embolism of the pancreatic vessels causes local ischemia, capillary dilation and damage to the vessel wall; in patients with primary hyperparathyroidism, 7% have combined pancreatitis with severe disease and high mortality rate; 25% to 45% of patients have pancreatic parenchymal calcification and pancreatic duct stones. Stones can block the pancreatic duct, while calcium ions can activate pancreatic zymogen, which may be the main cause of pancreatitis. 5, surgical trauma upper abdominal surgery or trauma can cause pancreatitis. Post-surgical pancreatitis is mostly seen in abdominal surgery, such as pancreatic, biliary, gastric and duodenal surgery, and occasionally in non-abdominal surgery. The causes may be intraoperative pancreatic injury, intraoperative contamination, edema or dysfunction of the sphincter of Oddis, postoperative use of certain drugs such as anticholinergic, salicylic acid preparations, morphine, diuretics, etc. In addition, ERCP can also be complicated by pancreatitis, which mostly occurs in cases of difficult selective intubation and repeated pancreatic duct visualization. In general, the success rate of pancreatic duct cannulation during ERCP is more than 95%, but occasionally, after pancreatic duct imaging, selective bile duct cannulation is performed unsuccessfully, resulting in repeated pancreatic duct imaging, irritation and damage to the pancreatic duct opening; or the injection of infectious material to the distal end of the obstructed pancreatic duct due to lax aseptic operation; or the injection of excessive contrast agent, even leading to pancreatic alveoli and tissue imaging, inducing post-ERCP Pancreatitis. Foreign scholars believe that the incidence of post-ERCP pancreatitis is significantly higher when the pancreatic duct is repeatedly visualized for more than 3 times. In mild cases, only blood and urine amylase is elevated, while in severe cases, severe pancreatitis may occur, leading to death.