Current management of acute pancreatitis.

Abstract

Acute pancreatitis is a common disease, which internists encounter in general practice. After 20 years, the classification of acute pancreatitis has been revised as seen in Atlanta classification 2013, which classifies the severity of the disease into mild, moderately severe and severe acute pancreatitis. About 80% of patients with acute pancreatitis have a benign course. Currently, there are several clinical, laboratory and radiographic parameters to predict the severity of acute pancreatitis. Regardless of the severity of the disease, supportive care remains a key to the treatment, that includes ensuring adequate tissue perfusion and oxygenation, adequate pain control, nutritional management and intensive care in severe cases. Some patients with acute pancreatitis may develop local complication, such as acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection and infected or sterile wall-off necrosis. Supportive treatment could be continued in patients with local complication whose their clinical conditions remain stable. However, the intervention is always required if the patient’s condition deteriorates, or the local complication becomes symptomatic. The intervention may be endoscopic, percutaneous or surgical techniques. This review provides the most current information on the management of acute pancreatitis.