Acute Pancreatitis Questions & Answers

Updated: Jul 25, 2019
  • Author: Jeffrey C F Tang, MD; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

How is acute pancreatitis treated?

What are the signs and symptoms of acute pancreatitis?

Which findings in a patient history may suggest acute pancreatitis?

Which physical findings suggest acute pancreatitis?

Which physical findings suggest severe necrotizing pancreatitis?

What is the role of lab testing in the diagnosis of acute pancreatitis?

What is the role of imaging studies in the diagnosis of acute pancreatitis?

Is genetic testing useful in the diagnosis of acute pancreatitis?

How is acute pancreatitis classified?

How is acute pancreatitis managed initially?

What is the role of antibiotic therapy in the management of acute pancreatitis?

When is surgical intervention indicated for acute pancreatitis?

What is pancreatitis?

How does the presentation of chronic pancreatitis differ from that of acute pancreatitis?

How is the diagnosis of acute pancreatitis confirmed?

How is acute pancreatitis managed?

What is the pancreas and what does it do?

How does the exocrine pancreas function?

How does a normal pancreas function?

Which factors may trigger acute pancreatitis?

What is the pathogenesis of acute pancreatitis following a cellular injury?

What is acute edematous pancreatitis?

What are the risk factors for acute renal failure in acute pancreatitis?

What is the etiology of acute pancreatitis?

Can gallstones cause acute pancreatitis?

Does alcohol cause acute pancreatitis?

How much alcohol is required to cause acute pancreatitis?

What are the risk factors for developing post-ERCP acute pancreatitis?

What is the role of abdominal trauma or injury in the development of acute pancreatitis?

Which drugs can cause acute pancreatitis?

Which infections can cause acute pancreatitis?

Which genes may cause hereditary pancreatitis?

What causes of hypercalcemia may lead to acute pancreatitis?

Which development abnormalities cause pancreatitis?

What is pancreas divisum?

What is annular pancreas?

How does sphincter of Oddi dysfunction cause acute pancreatitis?

Does hyperlipidemia cause acute pancreatitis?

Which tumors cause acute pancreatitis?

Which toxins cause acute pancreatitis?

Can acute pancreatitis be a complication of surgery?

Do vascular factors cause acute pancreatitis?

What is autoimmune pancreatitis?

What is the incidence of acute pancreatitis in the US?

What is the global incidence of acute pancreatitis?

What age groups are most affected by acute pancreatitis?

Is acute pancreatitis more prevalent in males or females?

Does acute pancreatitis have a racial predilection?

What is the mortality rate associated with acute pancreatitis?

What are the most common causes of death in patients with acute pancreatitis?

What is the difference between mild and severe acute pancreatitis?

Which methods are used to predict the outcome of acute pancreatitis?

Does the neutrophil-lymphocyte ratio (NLR) have prognostic value in severe acute pancreatitis?

How does nonalcoholic fatty liver affect the prognosis of acute pancreatitis?

How are pseudocysts detected in acute pancreatitis?

Which organisms may cause intra-abdominal infection in acute pancreatitis?

What is pancreatic necrosis and how is it diagnosed and treated?

Can acute pancreatitis cause intra-abdominal hemorrhage?

What education information should be provided to patients with acute pancreatitis?

Presentation

Which characteristics of abdominal pain suggest acute pancreatitis?

What are the symptoms of acute pancreatitis?

What is the focus of the medical history in a patient who presents with symptoms of acute pancreatitis?

Which physical findings suggest acute pancreatitis?

Which physical findings suggest severe necrotizing pancreatitis?

DDX

Which disorders should be included in the differential diagnoses of acute pancreatitis?

What are the differential diagnoses for Acute Pancreatitis?

Workup

How is a diagnosis of acute pancreatitis confirmed?

What are the ACG guidelines for the management of acute pancreatitis?

What are the AGA guidelines for the initial management of acute pancreatitis and for the diagnosis/management of asymptomatic neoplastic pancreatic cysts?

What are the ACG recommendations for the diagnosis and management of asymptomatic neoplastic pancreatic cysts?

What is the role of serum amylase and lipase testing in the diagnosis of acute pancreatitis?

What is the role of liver enzyme testing in the diagnosis of acute pancreatitis?

What is the role blood tests in the diagnosis of acute pancreatitis?

What is the role of a CBC count in the diagnosis of acute pancreatitis?

Does hemoconcentration suggest acute pancreatitis?

What is the role of C-reactive protein (CRP) testing in the diagnosis of acute pancreatitis?

When are arterial blood gases evaluated in acute pancreatitis?

Why are lactic dehydrogenase (LDH), BUN, and bicarbonate levels measured in acute pancreatitis?

What is the role of IgG4 testing in the diagnosis of acute pancreatitis?

What is the role of trypsin and trypsinogen-2 in the diagnosis of acute pancreatitis?

Is genetic testing useful in predicting the severity of acute pancreatitis?

What is the role of abdominal X-ray in the diagnosis of acute pancreatitis?

What is the role of abdominal ultrasonography in the diagnosis of acute pancreatitis?

What are the benefits of endoscopic ultrasonography (EUS) in the diagnosis of acute pancreatitis?

What is the role of endoscopic ultrasonography (EUS) in the diagnosis of acute pancreatitis?

What is the role of abdominal CT scanning in the diagnosis of acute pancreatitis?

What prognostic information is provided by abdominal CT scans of the pancreas?

What is the role of dynamic spiral CT scanning in the diagnosis of acute pancreatitis?

What is the normal density range finding for a healthy pancreas on CT scanning?

How is MRCP used in the diagnosis of acute pancreatitis?

What is the role of ERCP in the diagnosis of acute pancreatitis?

What are the risk factors for post-ERCP pancreatitis?

Can infected necrotizing pancreatitis be differentiated from sterile necrotizing pancreatitis using CT-guided needle aspiration?

Can infected necrotizing pancreatitis be differentiated from sterile necrotizing pancreatitis using EUS-guided needle aspiration?

How can genetic testing be used in the diagnosis of acute pancreatitis?

Which genetic mutations are associated with hereditary pancreatitis?

Which genetic mutations are associated with idiopathic pancreatitis?

Which genetic mutations may predispose an individual to develop acute pancreatitis?

How are mild and severe pancreatitis differentiated histologically?

What are the Ranson criteria for staging acute pancreatitis?

What are the limitations of the Random criteria for staging acute pancreatitis?

Does an elevated BUN level at admission indicate increased severity of acute pancreatitis?

What are the advantages and limitations of APACHE II scoring for acute pancreatitis?

Which biological markers can be used to stage acute pancreatitis?

Are there genetic markers for acute pancreatitis?

Treatment

How is mild acute pancreatitis managed?

How is biliary-caused pancreatitis managed?

How is brain injury-caused pancreatitis managed?

How is severe acute pancreatitis managed?

How is autoimmune pancreatitis managed?

When should patients be transferred to a skilled medical center for acute pancreatitis?

How long should patients with acute pancreatitis remain hospitalized?

How is hydration provided to patients with acute pancreatitis?

What are the guidelines for nutritional support in acute pancreatitis?

Should nasojejunal feedings be initiated in the treatment of acute pancreatitis?

Do nasojejunal tubes have an advantage over nasogastric tubes for enteral feeding in patients with acute pancreatitis?

When is TPN indicated in acute pancreatitis?

Which nutritional support method is the most effective in acute pancreatitis?

How are antibiotics used in the management of acute pancreatitis?

Is imipenem-cilastatin effective as a treatment of acute pancreatitis?

Are ciprofloxacin and metronidazole effective as a treatment of acute pancreatitis?

Is antibiotic prophylaxis recommended in severe pancreatitis?

Is lexipafant effective as a treatment for acute pancreatitis?

When is surgical intervention indicated in the treatment of acute pancreatitis?

When is cholecystectomy indicated in the treatment of gallstone pancreatitis?

How common is early cholecystectomy in nonsevere acute gallstone pancreatitis?

When is cholecystectomy indicated for severe acute gallstone pancreatitis?

How is pancreatic duct disruption in acute pancreatitis diagnosed and managed?

How are pancreatic pseudocysts differentiated from true cysts?

When is intervention indicated for pancreatic pseudocysts in patients with acute pancreatitis?

When is percutaneous aspiration of pancreatic pseudocysts indicated in patients with acute pancreatitis?

Can pancreatic pseudocysts be managed endoscopically?

How effective is transmural enterocystostomy for pancreatic pseudocysts?

When is surgery indicated for pancreatic pseudocysts in patients with acute pancreatitis?

How is infected pancreatic necrosis managed in patients with acute pancreatitis?

How are pancreatic abscesses treated in patients with acute pancreatitis?

How is acute pancreatitis prevented?

When is consultation required in the treatment of acute pancreatitis?

Which consultations are necessary in the treatment of alcohol-induced pancreatitis?

Which consultations are necessary for patients with hypertriglyceridemia- or hypercalcemia-induced pancreatitis?

Which consultations are indicated in the treatment of gallstones or microlithiasis in acute pancreatitis?

Which consultations are indicated in the treatment of medication-induced acute pancreatitis?

What routine follow-up is indicated after hospital discharge of patients with acute pancreatitis?

Are there guidelines for outpatient follow-up care for acute pancreatitis?

How is recurrent acute pancreatitis evaluated and managed?

Medications

What is the goal of pharmacotherapy for acute pancreatitis?

Which medications in the drug class Analgesics, Other are used in the treatment of Acute Pancreatitis?

Which medications in the drug class Antibiotics, Other are used in the treatment of Acute Pancreatitis?