Definition – Acute pancreatitis is a sudden inflammation of the pancreas. Causes in order of frequency include: 1)Gallstones are the commonest cause of pancreatitis. A stone impacted in the common bile duct beyond the point where the pancreatic duct joins it can cause pancreatitis 2) Heavy alcohol use 3) Systemic disease 4) Trauma Acute pancreatitis may be a single event; it may be recurrent; or it may progress to chronic pancreatitis Common Symptoms Severe epigastric pain (upper abdominal pain) radiating to the back in 50% of cases Nausea Vomiting Fever Chills (shivering) Hemodynamic instability, including shock Tachycardia (rapid heartbeat) Respiratory distress Peritonitis DIAGNOSIS Acute pancreatitis is diagnosed using clinical history and physical examination, based on the presence of at least 2 of 3 criteria: abdominal pain, elevated serum lipase or amylase abdominal imaging findings consistent with acute pancreatitis Additional blood studies are used to identify organ failure, offer prognostic information, and determine if fluid resuscitation is adequate and whether ERCP is necessary. Blood investigations complete blood count kidney function tests, liver function, serum calcium, serum amylase, and lipase Imaging – A triple-phase abdominal CT and abdominal ultrasound are together considered the gold standard for the evaluation of acute pancreatitis. An important caveat is that imaging during the first 12 hours may be falsely reassuring as the inflammatory and necrotic process usually requires 48 hours to fully manifest Treatment Treatment for acute pancreatitis depends on its severity. For people with mild cases, the risk of complications is low, and the symptoms may resolve after a few days. In severe cases, the risk is significant. Treatment for severe acute pancreatitis Severe cases often involve some tissue death or necrosis. This increases the risk of sepsis, a severe bacterial infection that can affect the whole body. Sepsis can lead to multiorgan damage or failure. Severe acute pancreatitis can also cause hypovolemic shock. This involves severe blood and fluid loss leaving the heart unable to pump enough blood to the body. If this happens, parts of the body can rapidly become deprived of oxygen. Treating gallstones If gallstones are responsible for acute pancreatitis, the doctor will recommend surgery for the removal of gallstones.
