Evaluation and management of acute pancreatitis

Table 3 Complications of acute pancreatitis

Region	Complications	Manifestation
Local	Interstitial Edematous Pancreatitis	Description: Acute inflammation of parenchyma or peripancreatic tissues; Radiology: Enhancement of the pancreatic parenchyma with no signs of necrosis
	Necrotizing Pancreatitis	Description: Necrosis encompassing pancreatic parenchyma or pancreatic tissues; Radiology: Acute necrotic collection lacking definable wall containing variable amounts of fluid OR Walled off necrosis containing a well-defined encapsulated collection
	Acute peripancreatic Fluid Collection	Description: Homogenous collection of fluids with no distinct inflammatory walls outside pancreas containing minimal or no necrosis; Timing: Within the first four weeks after onset of interstitial edema; Radiology: Homogenous collection with fluid confined by normal fascial planes
	Pancreatic Pseudocyst	Description: Collections of fluids that contain distinct inflammatory walls outside the pancreas containing minimal to no necrosis; Timing: After four weeks of initial onset of interstitial edematous pancrea-titis; Radiology: Clear homogenous fluid density with well-defined borders that is encapsulated
	Acute Necrotic Collection	Description: Collection of both fluid and necrosis associated with necrotizing pancreatitis; Radiology: intrapancreatic or extrapancreatic heterogenous non-liquid density of varying degrees with no definite wall
	Walled Off Necrosis	Description: Encapsulated collection of pancreatic or peripancreatic necrosis that has formed a distinct inflammatory wall; Radiology: Heterogenous liquid/non-liquid density with varying loculations. The structure has a well demarcated wall that is en-tirely encapsulated
Peripancreatic	Thrombosis	Description: Thrombosis of splanchnic venous circulation including splenic vein, portal and/or superior mesenteric veins
	Pseudoaneurysm	Description: Collection of blood forming between the two most outer layer of the artery – muscularis propria and adventitia
	Abdominal Compartment Syndrome	Description: Tissue edema that is secondary to aggressive fluid resuscitation, peripancreatic inflammation and ascites