BMJ  2006;332:1072-1076 (6 May), doi:10.1136/bmj.332.7549.1072

Clinical review

Acute pancreatitis

¹ Derriford Hospital, Plymouth PL6 8DH, ² Department of Surgery, University Hospital Aintree, Liverpool

The first 150 words of the full text of this article appear below.

Introduction

Acute pancreatitis is a potentially lethal disease that is increasing in incidence. The high mortality associated with acute pancreatitis has improved as a result of a greater understanding of the natural history of acute pancreatitis and recent advances in critical care. Optimal management requires a greater willingness to consider the diagnosis of acute pancreatitis, stratification of severity, and adequate fluid resuscitation. Here, we review who gets acute pancreatitis and how to deal with those patients in whom the cause remains unclear. We also examine the current controversies in acute pancreatitis: how to deliver nutritional support, what role exists for antibiotic prophylaxis, when to do a computed tomography scan, and the role of early endoscopic retrograde cholangiopancreatography (ERCP).

Is acute pancreatitis becoming more common?

Incidence rates vary from 5.4 per 100 000 population per year to 79.8 per 100 000 per year. Variation is due to different diagnostic criteria, geographical factors, and changes over time. One constant, . . . [Full text of this article]

How does acute pancreatitis present?

What is the initial management?

How is it diagnosed?

How can disease severity be predicted?

What causes acute pancreatitis?

How should idiopathic acute pancreatitis be investigated?

When is a computed tomography scan indicated?

When and how should nutritional support be implemented?

Do antibiotics have a role?

How should gallstones be managed?

How should pancreatic necrosis be managed?

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