Acute Pancreatitis: Symptoms, Causes & Treatment

Acute pancreatitis is sudden inflammation of the pancreas, ranging from mild, self-limiting disease to severe, life-threatening systemic inflammation.

Symptoms

• Severe epigastric pain radiating to back
• Nausea, vomiting
• Fever, tachycardia, hypotension (in severe cases)
• Confusion (in severe systemic inflammation)

Common Causes

1. Gallstones (40–70%)
2. Alcohol (25–35%)
3. Medications (azathioprine, valproate, GLP-1 agonists, etc.)
4. Hypertriglyceridemia (>1000 mg/dL)
5. ERCP (post-procedure)
6. Trauma, infections, genetic mutations (PRSS1, SPINK1, CFTR)
7. Idiopathic

Treatment

• Mild: Aggressive IV hydration, analgesia, early oral feeding as tolerated.
• Moderate/severe: ICU monitoring, goal-directed fluid resuscitation, nutritional support (enteral preferred), antibiotics only for infected necrosis.
• Interventions: ERCP for cholangitis/obstructing stone; percutaneous/endoscopic necrosectomy for infected necrosis.

Prevention

• Limit alcohol
• Treat gallstones (cholecystectomy if symptomatic)
• Control triglycerides
• Avoid offending medications