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

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

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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