Acute pancreatitis

James Lucocq, Sanjay Pandanaboyana
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Abstract

Acute pancreatitis (AP) is a significant cause of morbidity worldwide, with a steadily rising incidence, particularly in Western nations. This article provides a comprehensive overview of the epidemiology, aetiology, pathophysiology, and management of AP. The various aspects of the Revised Atlanta classification system are emphasized for its utility in defining AP severity, stratifying risk and guiding treatment. Both the role of imaging and the ‘step-up’ approach to guide procedural and endoscopic management are discussed, demonstrating the shift towards minimally invasive techniques. Early recognition of organ dysfunction and supportive care, including judicious fluid management, nutritional support, and appropriate use of antibiotics, are critical to improving outcomes. Specific considerations and recommendations for the management of local and systemic complications are outlined, with recommendations for early referral to specialized centres for optimal care.
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