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Acute management of pancreatitis: the key to best outcomes
  1. Erik Olson1,
  2. Alexander Perelman2,
  3. John W Birk3
  1. 1 Department of Gastroenterology and Hepatology, Rochester General Hospital, Rochester, New York, USA
  2. 2 Gastroenterology, UConn Health, Farmington, Connecticut, USA
  3. 3 Gastroenterology-Hepatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
  1. Correspondence to Dr Alexander Perelman, Gastroenterology, UConn Health, Farmington, CT 06030, USA; perelman{at}


Acute pancreatitis (AP) accounts for over 230 000 US and 28 000 UK hospital admissions annually. Abdominal pain is the most common presenting symptom in AP but may not reflect severity. The clinical challenge is identifying the 20% of patients in whom AP will be severe. We summarise the common aetiologies, the risk stratification strategies including the simplified Bedside Index for Severity in Acute Pancreatitis, acute management approaches in the initial presentation setting, conditions for using advance imaging and opinions on antibiotic use. Some warning signs of impending complications are also discussed.

  • pancreatic disease
  • abdominal pain
  • clinical management
  • acute pancreatitis

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  • Contributors JWB: conception, reviewed, edited and rewrote sections of manuscript. EO: wrote original draft and did edits. AP: edited manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.