Acute Pancreatitis

Most patients with acute pancreatitis experience abdominal pain, usually in the epigastrium, with radiation to the back in approximately half of cases. Acute pancreatitis is divided into two pathological types, namely interstitial edematous pancreatitis and necrotizing pancreatitis. The diagnosis of acute pancreatitis requires two of the following three features: abdominal pain characteristic of acute pancreatitis; serum amylase and/or lipase three or more times the upper limit of normal; and characteristic findings of acute pancreatitis on transabdominal ultrasound, contrast-enhanced computed tomography (CT) scan or magnetic resonance imaging (MRI). Early assessment of the severity and expected prognosis of acute pancreatitis is of paramount importance because most of the therapeutic approaches are aimed at symptomatic relief rather than addressing causation. Therefore, close monitoring and appropriate symptomatic therapy should be initiated as early as possible in cases of severe pancreatitis. In patients with severe acute pancreatitis, the need for early resuscitation is usually clear.