Highlights & Basics
- Acute pancreatitis most commonly presents as severe mid-epigastric or left upper quadrant pain that radiates to the back. Epigastric tenderness is typical.
- Symptoms often include nausea and vomiting. A history of cholelithiasis or alcohol intake may be present.
- Signs of hypovolemia (including decreased skin turgor, dry mucous membranes, hypotension, and sweating) are common. In more severe cases, the patient may be tachycardic and/or tachypneic.
- In most patients who present with typical clinical signs, the diagnosis is confirmed by elevated serum lipase or amylase (>3 times upper limit of normal).
- Treatment includes moderately aggressive fluid resuscitation with close monitoring, analgesia, and nutritional support, with early oral feeding favored if tolerated.
Quick Reference
History & Exam
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Citations
Tenner S, Vege S, Sheth S, et al. American College of Gastroenterology guidelines: management of acute pancreatitis. Am J Gastroenterol. 2024 Mar 119(3):419-37.[Abstract][Full Text]
Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019 Jun 13;14:27.[Abstract][Full Text]
Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15.[Abstract][Full Text]
American College of Radiology. ACR appropriateness criteria: acute pancreatitis. 2019 [internet publication].[Full Text]
Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis. Gastroenterology. 2018 Mar;154(4):1096-101.
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