Discussion
Alcohol use and gallstones are responsible for the development of more than 80% of acute pancreatitis cases. Other common causes of acute pancreatitis are hypertriglyceridemia and hypercalcemia. Drugs are implicated in the etiology of approximately 2% of cases [13]. Drug-induced acute pancreatitis has a good prognosis and can be diagnosed by exclusion. Absence of gallstones, lack of a history of alcohol use with normal serum lipid and calcium levels and history of a recently started new medication support the diagnosis [13,14]. Orlistat blocks intestinal fat absorption by inhibiting gastric and pancreatic lipase and thus can cause symptoms such as rectal pain, oily feces, frequent defecation, nausea and vomiting. All these lead to a modification of the patient's behavior and eating habits to avoid eating fat, with the patient consequently losing weight [5]. Orlistat is metabolized in the gastrointestinal tract and its direct destructive effect is shown in intestinal villi of animal models [4]. However, the mechanism in the development of acute pancreatitis is not known; a possible mechanism may be direct toxicity or hypersensitivity such as in other drug-induced acute pancreatitis.