Acute pancreatitis

Acute pancreatitis is an inflammatory disease with a varied clinical course. The diagnosis is based upon the clinical presentation, laboratory indices and imaging studies, whilst the severity of the illness can be assessed by bedside scoring systems such as the Ranson, Glasgow or APACHE-II criteria, or by the CT severity index. Most patients develop self-limited disease, but a minority progress to a severe form with local and systemic complications. Management is usually conservative with interventional therapy reserved for those with complications such as pancreatic abscess and pseudocyst formation. This article also examines controversial issues related to the current management of pancreatitis, including the route of nutritional support, appropriate use of antibiotics and the timing and indications for interventional therapy.