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37 - Acute pancreatitis

from Section 6 - Gastrointestinal emergencies

Published online by Cambridge University Press:  05 November 2013

By
John Woodruff  and
Abigail Hankin
Edited by
Kaushal Shah ,
Jarone Lee ,
Kamal Medlej  and
Scott D. Weingart
Kaushal Shah
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
Jarone Lee
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston
Kamal Medlej
Affiliation:
American University of Beirut
Scott D. Weingart
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
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Summary

This chapter discusses the diagnosis, evaluation and management of acute pancreatitis. Historical features of pancreatitis include its characteristic abdominal pain, classically described as epigastric in location and radiating to the back. This is typically associated with nausea and vomiting. Multiple scoring systems have been developed to predict the severity of illness in acute pancreatitis, but none of them should replace regular reassessment of the patient's clinical condition. The most commonly used scoring system is the Ranson score. A frequently cited definition of pancreatitis is the presence of at least two of the following: upper abdominal pain; serum lipase at least 3 times greater than the upper limit of normal; and CT findings suggestive of acute pancreatitis. Laboratory findings in acute pancreatitis most importantly include elevated serum levels of lipase and amylase.

Keywords

respiratory distressnoninvasive positive-pressure ventilationpulmonary vascular congestionhypoxiachest paindiaphoresisacute decompensated heart failure
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 245 - 252
Publisher: Cambridge University Press
Print publication year: 2013

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