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Pancreatitis, Acute

Robert L. Frachtman, MD and Marni L. Martinez, APRN Reviewed 06/2020
 


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, an...

DIAGNOSIS

Symptoms don’t always correlate with objective findings. 

HISTORY

  • Acute onset of “boring” epigastric pain, which may radiate toward the back

  • Nausea/vomiting

  • Alcohol use

  • Personal or family history...

TREATMENT

GENERAL MEASURES

Most 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 continues to be elevated. Follow-up find...

REFERENCES

1
Habtezion A, Gukovskaya AS, Pandol SJ. Acute pancreatitis: a multifaceted set of Organelle and cellular interactions. Gastroenterology.  2019;156(7):1941–1950.
2
Forsmark CE, Vege SS, W...

ADDITIONAL READING

Crockett SD, Wani S, Gardner TB, et al; for American Gastroenterological Association Institute Clinical Guidelines Committee. American Gastroenterological Association Institute guid...

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

  • Pancreatitis is a common cause of hospitalization.

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

  • The BISAP score is easier to apply than Ranson criteria and just ...

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