Diagnosis and Management of Acute Pancreatitis

Acute pancreatitis is an inflammatory condition of the exocrine pancreas that is a common indication for hospital admission and has had an increasing incidence in the last few decades. The diagnosis of acute pancreatitis requires the satisfaction of two out of three criteria: (1) abdominal pain radi...

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Main Authors: Nitish Mittal, Veeral M. Oza, Thiruvengadam Muniraj, Truptesh H. Kothari
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/3/258
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author Nitish Mittal
Veeral M. Oza
Thiruvengadam Muniraj
Truptesh H. Kothari
author_facet Nitish Mittal
Veeral M. Oza
Thiruvengadam Muniraj
Truptesh H. Kothari
author_sort Nitish Mittal
collection DOAJ
description Acute pancreatitis is an inflammatory condition of the exocrine pancreas that is a common indication for hospital admission and has had an increasing incidence in the last few decades. The diagnosis of acute pancreatitis requires the satisfaction of two out of three criteria: (1) abdominal pain radiating to the back, (2) serum lipase or amylase levels three or more times the upper limit of the normal level, and (3) findings indicating pancreatitis obtained via a computed tomography (CT) scan or magnetic resonance imaging (MRI). The different etiologies include gallstones, autoimmune disorders, alcohol abuse, smoking, hypertriglyceridemia, obesity, drugs, and post-endoscope retrograde cholangiopancreatography (ERCP). The initial investigation includes serum amylase and lipase analysis, a lipid panel including triglycerides, analysis of immunoglobulins, a full blood count, electrolyte analysis, a hemoglobin A1c test, a complete metabolic panel, and transabdominal ultrasound. The initial therapy includes oxygen supplementation, the provision of intravenous fluids, pain control, and a nutrition regime. Early oral feeding is encouraged if tolerated; if not, liquid supplement provision or enteral tube feeding within 48 h of admission has shown better outcomes. Some complications of acute pancreatitis are necrosis, infection, insulin resistance leading to diabetes mellitus, and pancreatic exocrine insufficiency requiring enzyme supplementation. Patients need to attend regular follow-ups and abstain from alcohol and smoking (if warranted) to prevent the recurrence of acute pancreatitis. The mortality rate of acute pancreatitis has decreased in the past few decades because of better management skills, but the recent rise in acute pancreatitis episodes is concerning. Sustained endeavors through clinical trials are required to establish a broad variety of drugs that can be used for acute pancreatitis episodes.
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spelling doaj-art-42a7d2c870dc4a39bf2f17063ba8459e2025-08-20T03:12:35ZengMDPI AGDiagnostics2075-44182025-01-0115325810.3390/diagnostics15030258Diagnosis and Management of Acute PancreatitisNitish Mittal0Veeral M. Oza1Thiruvengadam Muniraj2Truptesh H. Kothari3Department of Internal Medicine, The University of Texas Health Sciences Center, Houston, TX 77030, USADepartment of Internal Medicine, The University of Texas Health Sciences Center, Houston, TX 77030, USASection of Digestive Disease, Yale University School of Medicine, New Haven, CT 06520, USASection of Digestive Disease, University of Rochester Medical Center, Rochester, NY 14642, USAAcute pancreatitis is an inflammatory condition of the exocrine pancreas that is a common indication for hospital admission and has had an increasing incidence in the last few decades. The diagnosis of acute pancreatitis requires the satisfaction of two out of three criteria: (1) abdominal pain radiating to the back, (2) serum lipase or amylase levels three or more times the upper limit of the normal level, and (3) findings indicating pancreatitis obtained via a computed tomography (CT) scan or magnetic resonance imaging (MRI). The different etiologies include gallstones, autoimmune disorders, alcohol abuse, smoking, hypertriglyceridemia, obesity, drugs, and post-endoscope retrograde cholangiopancreatography (ERCP). The initial investigation includes serum amylase and lipase analysis, a lipid panel including triglycerides, analysis of immunoglobulins, a full blood count, electrolyte analysis, a hemoglobin A1c test, a complete metabolic panel, and transabdominal ultrasound. The initial therapy includes oxygen supplementation, the provision of intravenous fluids, pain control, and a nutrition regime. Early oral feeding is encouraged if tolerated; if not, liquid supplement provision or enteral tube feeding within 48 h of admission has shown better outcomes. Some complications of acute pancreatitis are necrosis, infection, insulin resistance leading to diabetes mellitus, and pancreatic exocrine insufficiency requiring enzyme supplementation. Patients need to attend regular follow-ups and abstain from alcohol and smoking (if warranted) to prevent the recurrence of acute pancreatitis. The mortality rate of acute pancreatitis has decreased in the past few decades because of better management skills, but the recent rise in acute pancreatitis episodes is concerning. Sustained endeavors through clinical trials are required to establish a broad variety of drugs that can be used for acute pancreatitis episodes.https://www.mdpi.com/2075-4418/15/3/258acute pancreatitisdiagnosismanagementgallstonesrecurrence
spellingShingle Nitish Mittal
Veeral M. Oza
Thiruvengadam Muniraj
Truptesh H. Kothari
Diagnosis and Management of Acute Pancreatitis
Diagnostics
acute pancreatitis
diagnosis
management
gallstones
recurrence
title Diagnosis and Management of Acute Pancreatitis
title_full Diagnosis and Management of Acute Pancreatitis
title_fullStr Diagnosis and Management of Acute Pancreatitis
title_full_unstemmed Diagnosis and Management of Acute Pancreatitis
title_short Diagnosis and Management of Acute Pancreatitis
title_sort diagnosis and management of acute pancreatitis
topic acute pancreatitis
diagnosis
management
gallstones
recurrence
url https://www.mdpi.com/2075-4418/15/3/258
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AT veeralmoza diagnosisandmanagementofacutepancreatitis
AT thiruvengadammuniraj diagnosisandmanagementofacutepancreatitis
AT trupteshhkothari diagnosisandmanagementofacutepancreatitis