Acute pancreatitis

Treatment

Treatment is aimed at supportive measures such as fluid replacement by intravenous (IV) infusion, pain relief, and withholding food or fluid by mouth (to limit the activity of the pancreas that makes symptoms worse). Occasionally nasogastric suctioning may be required, if there is persistent vomiting or severe pain, or if a paralytic ileus develops.

Recurrent attacks may be prevented by treating the underlying condition.

In some cases, radiologic or endoscopic therapy is needed to remove gallstones, relieve obstructions of the pancreatic duct, or drain fluid collections in or around the pancreas. In the most severe cases, surgery is necessary to remove dead, infected pancreatic tissue.

Outlook (Prognosis)

While most cases go away in a week, some cases develop into a life-threatening illness. The death rate is high with hemorrhagic pancreatitis or necrotizing pancreatitis, and complications such as liver, heart, or kidney impairment may occur. Recurrences are common.

Possible Complications

• Low blood pressure
• Heart failure
• Kidney failure
• ARDS (acute respiratory distress syndrome)
• Ascites (accumulation of fluid in the abdomen)
• Cysts or abscesses in the pancreas

When to Contact a Medical Professional

Call your provider if intense, constant abdominal pain is present, or if other symptoms suggestive of acute pancreatitis develop.

References

Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006 Oct;101(10):2379-400.