Acute pancreatitis

The most common presenting symptom is mid-epigastric or left upper quadrant pain that radiates to the back. Epigastric tenderness is typical.

Associated with nausea and vomiting. A history of cholelithiasis or alcohol intake is often present.

Signs of hypovolemia (including decreased skin turgor, dry mucous membranes, hypotension, and sweating) are common. In more severe cases, the patient may be tachycardic and/or tachypneic.

Elevated serum lipase or amylase concentration supports, but is not pathognomonic for, the diagnosis of acute pancreatitis.

Initial treatment includes resuscitation with intravenous fluids and correction of electrolyte abnormalities, analgesia, and tight glucose control.

Treatment of severe acute pancreatitis includes support of end organ failure, most commonly of respiratory, renal, and circulatory systems.

A disorder of the exocrine pancreas and is associated with acinar cell injury with local and systemic inflammatory responses.[1]Nirula R. Chapter 9: Diseases of the pancreas. High yield surgery. Philadelphia, PA: Lippincott Williams & Wilkins; 2000. The severity of the disease ranges from mild pancreatic edema with full recuperation to severe systemic inflammatory response with pancreatic/peripancreatic necrosis, multiple organ failure, and death.