Acute pancreatitis approach

Jump to navigation Jump to search

Acute pancreatitis Microchapters

Home

American College of Gastroenterology Guidelines

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Acute Pancreatitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Approach to Therapy

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Acute pancreatitis approach On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute pancreatitis approach

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute pancreatitis approach

CDC on Acute pancreatitis approach

Acute pancreatitis approach in the news

Blogs on Acute pancreatitis approach

Directions to Hospitals Treating Acute pancreatitis

Risk calculators and risk factors for Acute pancreatitis approach

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]

Overview

The mainstay of treatment in acute pancreatitis involves pain control, bowel rest (NPO or nothing by mouth), and fluid resuscitation. Assessment of the re-introduction of feeding and nutritional support must be made subsequently based on clinical improvement and imaging findings. Serial cross sectional imaging may be used to determine the need for surgical intervention secondary to complications. Antiobiotics may only be used in cases when infection is suspected or confirmed. Clinicians must note that imaging findings almost always lag the clinical findings. Clinicians must make decisions primarily based on the patient's clinical condition. Cross-sectional imaging modalities may shed light to the local complications associated with acute pancreatitis and minimally invasive surgery may be performed to manage some complications (e.g. pancreatic necrosis).

Approach to Therapy

According to the American college of gastroenterology, following are the guidelines for initial assessment and risk stratification for acute pancreatitis:[1]

Recommendation Evidence Level Strength of Recommendation
Hemodynamic status should be assessed immediately upon presentation and resuscitative measures begun as needed Moderate Strong
Risk assessment should be performed to stratify patients into higher- and lower-risk categories to assist triage, such as admission to an intensive care setting Moderate Conditional
Patients with organ failure should be admitted to an intensive care unit or intermediary care setting whenever possible Low Strong
Intrinsic patient related risk factors
Patient characteristics Age >55 years
Obesity (BMI>30kg/m)
Altered mental status
Comorbid disease
The systemic inflammatory response syndrome (SIRS)

Presence of >2 of the following criteria

References

  1. Tenner S, Baillie J, DeWitt J, Vege SS, American College of Gastroenterology (2013). "American College of Gastroenterology guideline: management of acute pancreatitis". Am J Gastroenterol. 108 (9): 1400–15, 1416. doi:10.1038/ajg.2013.218. PMID 23896955.

Template:WHTemplate:WS