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Pancreatitis, Acute

Robert L. Frachtman, FACG, MD and Marni L. Martinez, APRN Reviewed 05/2023
 


BASICS

DESCRIPTION

Acute inflammation of the pancreas with variable involvement of regional tissue or remote organ systems 
  • Symptoms relate to intrapancreatic activation of enzymes with pain, nausea and...

DIAGNOSIS

Symptoms don’t always correlate with objective findings. 

HISTORY

  • Acute onset of “boring” epigastric pain, which may radiate posteriorly

  • Nausea/vomiting

  • Alcohol use

  • Personal or family history of ...

TREATMENT

GENERAL MEASURES

  • Many cases of acute pancreatitis require hospitalization; ICU if multiorgan dysfunction or hypotension/respiratory failure; 15–20% of cases of acute pancreatitis progress fro...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow-up imaging in several weeks if the original CT scan showed a fluid collection or necrosis or if the amylase/lipase continue to be elevated. Follow-up findi...

REFERENCES

1
Gardner T. Fluid resuscitation in acute pancreatitis—going over the waterfall. N Engl J Med. 2022;387:1038-1039.
2
Gulati A, Papachristou GI. Update on the management of acute pancreatitis a...

ADDITIONAL READING

CODES

ICD10

  • K85.9 Acute pancreatitis, unspecified

  • K85.8 Other acute pancreatitis

  • K85.2 Alcohol induced acute pancreatitis

  • K85.3 Drug induced acute pancreatitis

  • K85.1 Biliary acute pancreatitis

  • K85.0 Idiopat...

CLINICAL PEARLS

  • Gallstones and alcohol misuse are the leading causes of pancreatitis.

  • The BISAP score is easier to apply than Ranson criteria and just as accurate for predicting mortality.

  • Review all me...

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