Acute pancreatitis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 5 of 2020

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting acute pancreatitis or death from acute pancreatitis with the circumstances of a person's relevant service:

1. (1)
   smoking at least 15 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of acute pancreatitis, and where smoking has ceased, the clinical onset of acute pancreatitis has occurred within ten years of cessation;

   Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

2. (2)
   consuming an average of at least 420 grams of alcohol per week for at least the ten years before the clinical onset of acute pancreatitis;

   Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

3. (3)
   having cholelithiasis at the time of the clinical onset of acute pancreatitis;
4. (4)
   having biliary microlithiasis or biliary sludge at the time of the clinical onset of acute pancreatitis;

   Note: biliary microlithiasis or biliary sludge is defined in the Schedule 1 - Dictionary.

5. (5)
   having pancreatic outflow obstruction due to a disorder from the specified list at the time of the clinical onset of acute pancreatitis;

   Note: pancreatic outflow obstruction is defined in the Schedule 1 - Dictionary.

6. (6)
   having penetrating or major blunt trauma to the upper abdomen or to the back, within the seven days before the clinical onset of acute pancreatitis;
7. (7)
   having a spinal cord injury within the seven days before the clinical onset of acute pancreatitis;
8. (8)
   undergoing a procedure from the specified list of procedures, within the 30 days before the clinical onset of acute pancreatitis;

   Note: specified list of procedures is defined in the Schedule 1 - Dictionary.

9. (9)
   undergoing endoscopic retrograde cholangio-pancreatography, endoscopic sphincterotomy of the sphincter of Oddi, or manometry of the sphincter of Oddi within the seven days before the clinical onset of acute pancreatitis;
10. (10)
    undergoing a course of peritoneal dialysis or haemodialysis for renal disease at the time of the clinical onset of acute pancreatitis;
11. (11)
    having a solid organ transplant before the clinical onset of acute pancreatitis;
12. (12)
    being treated with a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical onset of acute pancreatitis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

13. (13)
    being treated with a drug which is associated in the individual with: (a) the development of the symptoms or signs of acute pancreatitis within two months of commencing drug therapy; and (b) the cessation of the symptoms or signs of acute pancreatitis following the discontinuation of drug therapy; and (c) an absence of clinical or laboratory evidence of acute pancreatitis prior to beginning drug therapy; and (d) where treatment with the drug continued for at least the three days before the clinical onset of acute pancreatitis;
14. (14)
    having diabetes mellitus at the time of the clinical onset of acute pancreatitis;
15. (15)
    having hypertriglyceridaemia resulting in triglyceride levels above 11.3 millimoles per litre (or 1 000 milligrams per decilitre) at the time of the clinical onset of acute pancreatitis;
16. (16)
    having hypercalcaemia at the time of the clinical onset of acute pancreatitis;
17. (17)
    having a disease from the specified list of diseases at the time of the clinical onset of acute pancreatitis;

    Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

18. (18)
    having a disorder resulting in disseminated intravascular coagulation and/or profound systemic hypotension with pancreatic acinar damage within the seven days before the clinical onset of acute pancreatitis;
19. (19)
    having an acute infection with an organism at the time of the clinical onset of acute pancreatitis;

    Note: acute infection with an organism is defined in the Schedule 1 - Dictionary.

20. (20)
    having infection with human immunodeficiency virus at the time of the clinical onset of acute pancreatitis;
21. (21)
    having an infestation from the specified list of infestations at the time of the clinical onset of acute pancreatitis;

    Note: specified list of infestations is defined in the Schedule 1 - Dictionary.

22. (22)
    being envenomated by a snake or scorpion from the specified list within the seven days before the clinical onset of acute pancreatitis;

    Note: snake or scorpion from the specified list is defined in the Schedule 1 - Dictionary.

23. (23)
    having acute toxicity after oral ingestion of mushrooms containing alpha-amanitin within the seven days before the clinical onset of acute pancreatitis;

    Note: alpha-amanitin is defined in the Schedule 1 - Dictionary.

24. (24)
    ingesting an agent from the specified list of agents and experiencing acute toxicity within the seven days before the clinical onset of acute pancreatitis;

    Note: specified list of agents is defined in the Schedule 1 - Dictionary.

25. (25)
    for severe acute pancreatitis only, being obese at the time of the clinical onset of acute pancreatitis;

    Note: being obese and severe acute pancreatitis are defined in the Schedule 1 - Dictionary.

26. (26)
    inability to obtain appropriate clinical management for acute pancreatitis;

Aggravation-only factors: the factors in subsection 9(26) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.