Acute pancreatitis

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Última revisão: 18 Sep 2025
Última atualização: 24 Oct 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • abdominal pain
  • nausea and vomiting
  • anorexia
  • signs of hypovolemia
Detalhes completos

Outros fatores diagnósticos

  • signs of organ dysfunction
  • Grey-Turner sign
  • Cullen sign
  • Fox sign
  • abdominal distention
Detalhes completos

Fatores de risco

  • middle-aged women
  • young- to middle-aged men
  • gallstones
  • alcohol
  • hypertriglyceridemia
  • hypercalcemia
  • use of causative drugs
  • mumps
  • coxsackievirus
  • Mycoplasma pneumoniae
  • endoscopic retrograde cholangiopancreatography (ERCP)
  • trauma
  • pancreas divisum
  • pancreatic cancer
  • sphincter of Oddi dysfunction
  • family history of pancreatitis
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • serum lipase (or amylase if lipase is unavailable)
  • liver function tests
  • CBC and differential
  • hematocrit
  • BUN and serum electrolytes
  • arterial blood gas
  • CRP
  • transabdominal ultrasound
  • chest x-ray
  • ratio of serum lipase:amylase
  • serum triglycerides
Detalhes completos

Investigações a serem consideradas

  • abdominal CT scan
  • magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP)
  • endoscopic ultrasound (EUS)
Detalhes completos

Novos exames

  • procalcitonin
Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

CONTÍNUA

deteriorating or failing to improve

Colaboradores

Consultores especialistas

Scott Tenner, MD, MPH, JD, FACG

Clinical Professor of Medicine

Director, The Greater New York Endoscopy Surgical Center

Director, Brooklyn Gastroenterology and Endoscopy

State University of New York

NY

Declarações

ST is an author of references cited in this topic. He declares that he has no other competing interests.

Craig T. Tenner, MD, FACP

Associate Professor

Medicine

New York University School of Medicine

NY

Declarações

CTT declares that he has no competing interests.

Agradecimentos

Dr Scott Tenner and Dr Craig T. Tenner would like to gratefully acknowledge Dr Nicholas J. Zyromski, Dr Brian Daley, Dr Catherine Lindsay McKnight, and Dr Fernando Aycinena, previous contributors to this topic. They would also like to thank Dr Camille Blackledge for her contribution to this topic.

Declarações

NJZ is an author of a reference cited in this topic. BD, CLM, FA, and CB declare that they have no competing interests.

Revisores

Tamas A. Gonda, MD

Assistant Professor of Medicine

Attending Physician and Director of Research

Columbia University Medical Center

New York

NY

Declarações

TAG declares that he has no competing interests.

Alan Moss, MD

Harvard Medical Faculty Physician

Division of Gastroenterology

Beth Israel Deaconess Medical Center

Boston

MA

Declarações

AM declares that he has no competing interests.

Derek O'Reilly, MD

Consultant Hepatobiliary & Pancreatic Surgeon

Department of Surgery

North Manchester General Hospital

Manchester

UK

Declarações

DOR is an author of a reference cited in this topic. He declares that he has no other competing interests.

Eric Frykberg, MD

Professor

Department of Surgery

Division General Surgery

Shands Jacksonville Medical Center

FL

Declarações

At the time of the peer review, Dr E. Frykberg declared no competing interests. We were made aware that Dr Frykberg is now deceased.

Créditos aos pareceristas

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Referências

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Principais artigos

Tenner S, Vege S, Sheth S, et al. American College of Gastroenterology guidelines: management of acute pancreatitis. Am J Gastroenterol. 2024 Mar 119(3):419-37.Texto completo  Resumo

Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019 Jun 13;14:27.Texto completo  Resumo

Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15.Texto completo  Resumo

American College of Radiology. ACR appropriateness criteria: acute pancreatitis. 2019 [internet publication].Texto completo

Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis. Gastroenterology. 2018 Mar;154(4):1096-101.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diretrizes

    • ​American College of Gastroenterology guidelines: management of acute pancreatitis​​​​​​
    • American College of Gastroenterology guidelines: management of acute pancreatitis
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