Early management of acute pancreatitis

Abstract

Acute pancreatitis is the most common gastro-intestinal indication for acute hospitalization and its incidence continues to rise. In severe pancreatitis, morbidity and mortality remains high and is mainly driven by organ failure and infectious complications. Early management strategies should aim to prevent or treat organ failure and to reduce infectious complications. This review addresses the management of acute pancreatitis in the first hours to days after onset of symptoms, including fluid therapy, nutrition and endoscopic retrograde cholangiography. This review also discusses the recently revised Atlanta classification which provides new uniform terminology, thereby facilitating communication regarding severity and complications of pancreatitis.

Keywords: ACS; CARS; CBD; CECT; Diagnosis; ERC; ERCP; EUS; HES; ICU; IDUS; MRCP; MRI; Pancreas; Pancreatitis; Review; SIRS; Treatment; abdominal compartment syndrome; common bile duct; compensatory anti-inflammatory response syndrome; contrast-enhanced computed tomography; endoscopic retrograde cholangiography; endoscopic retrograde cholangiopancreatography; endoscopic ultrasound; hydroxyethyl starch; intensive care unit; intraductal ultrasound; magnetic resonance cholangiopancreatography; magnetic resonance imaging; systemic inflammatory response syndrome.