Acute management of pancreatitis: the key to best outcomes

Postgrad Med J. 2019 Jun;95(1124):328-333. doi: 10.1136/postgradmedj-2018-136034. Epub 2019 May 23.

Abstract

Acute pancreatitis (AP) accounts for over 230 000 US and 28 000 UK hospital admissions annually. Abdominal pain is the most common presenting symptom in AP but may not reflect severity. The clinical challenge is identifying the 20% of patients in whom AP will be severe. We summarise the common aetiologies, the risk stratification strategies including the simplified Bedside Index for Severity in Acute Pancreatitis, acute management approaches in the initial presentation setting, conditions for using advance imaging and opinions on antibiotic use. Some warning signs of impending complications are also discussed.

Keywords: abdominal pain; acute pancreatitis; clinical management; pancreatic disease.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Acute Disease
  • Amylases / metabolism
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Enteral Nutrition*
  • Fluid Therapy*
  • Gallstones / complications
  • Gallstones / diagnosis
  • Humans
  • Lipase / metabolism
  • Pancreatitis / diagnosis
  • Pancreatitis / etiology
  • Pancreatitis / therapy*
  • Pancreatitis, Alcoholic / diagnosis
  • Pancreatitis, Alcoholic / therapy
  • Severity of Illness Index

Substances

  • Lipase
  • Amylases