Acute Pancreatitis

Abstract

Pancreatitis is a leading differential diagnosis in patients presenting with abdominal pain. Although there are multiple initial inciting factors, the end result is the inappropriate activation of pancreatic enzymes leading to localized, and sometimes systemic, inflammation. The severity of pancreatitis as a disease can range from mild pain to shock and hypotension. This review covers the initial treatment and stabilization of patients with this disease as well as the mainstay of diagnosis including lab testing and imaging. Disease severity scoring systems including the revised Atlanta Criteria, APACHE II score, SIRS criteria, BISAP score, and Ranson criteria, followed by treatment and disposition stratified by disease severity, are discussed. Figures display pertinent findings of the imaging modalities including fluoroscopy, ultrasound, and computed tomography. Tables list the major causes of pancreatitis, differential diagnosis, and non-pancreatic causes of amylase and lipase elevation. This review contains 6 figures, 5 tables, and 53 references. Key words: pancreatitis, abdominal pain, shock, gallstones, ultrasound, lipase, amylase