Acute Pancreatitis

Written by Dr Andrew Lam

Pancreatitis

Diagnostic Criteria for Pancreatitis

Patients must fulfil 2 out of the following 3 criteria:

1. Clinical signs of pancreatitis (epigastric pain, often radiating to the back)
2. Serum amylase or lipase greater than 3x the upper limit of normal
3. Characteristic radiological findings of pancreatitis (i.e. on CT, Ultrasound or MRI) 

Causes of Pancreatitis

I – Idiopathic

G – Gallstones

E – Ethanol

T – Trauma

S – Steroids

M – Mumps/Malignancy

A – Autoimmune (IgG4 antibody may be present)

S – Scorpion Stings

H – Hypertriglyceridaemia/Hypercalcemia

E – ERCP 

D – Drugs (Hydrochlorothiazide, Bactrim, Azathioprine)

Complications of Pancreatitis

Local Complications

• Pancreatic pseudocysts +/- superimposed infection
• Pancreatic necrosis +/- superimposed infection
• Thrombosis of splanchnic vasculature
• Pseudoaneurysm

Systemic Complications

• Pancreatogenic Diabetes (Type 3c Diabetes)
• Hypocalcemia
• Acute Respiratory Distress Syndrome
• Abdominal Compartment Syndrome
• Exacerbation of underlying chronic disease (i.e. coronary artery disease, chronic kidney disease