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World J Clin Cases. May 6, 2019; 7(9): 1006-1020
Published online May 6, 2019. doi: 10.12998/wjcc.v7.i9.1006
Evaluation and management of acute pancreatitis
Ahmed T Chatila, Mohammad Bilal, Praveen Guturu
Ahmed T Chatila, Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX 77555, United States
Mohammad Bilal, Division of Gastroenterology and Hepatology, The University of Texas Medical Branch, Galveston, TX 77555, United States
Praveen Guturu, Division of Gastroenterology and Hepatology, the University of Texas Medical Branch, Galveston, TX 77555, United States
Author contributions: Bilal M and Guturu P were involved in concept design. Chatila AT, Bilal M and Guturu P wrote critical portions of the manuscript. Guturu P edited the manuscript and provided expert opinion.
Conflict-of-interest statement: The authors report no conflict of interest and have no financial disclosures with respect to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mohammad Bilal, MD, Academic Fellow, Doctor, Division of Gastroenterology and Hepatology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, United States. mobilal@utmb.edu
Telephone: +1-412-6603624 Fax: +1-409-7723394
Received: January 16, 2019
Peer-review started: January 17, 2019
First decision: March 10, 2019
Revised: March 19, 2018
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: May 6, 2019
Processing time: 111 Days and 7.6 Hours
Abstract

Acute pancreatitis (AP) is one of the most common gastrointestinal causes for hospi-talization in the United States. In 2015, AP accounted for approximately 390000 hospitalizations. The burden of AP is only expected to increase over time. Despite recent advances in medicine, pancreatitis continues to be associated with a substantial morbidity and mortality. The most common cause of AP is gallstones, followed closely by alcohol use. The diagnosis of pancreatitis is established with any two of three following criteria: (1) Abdominal pain consistent with that of AP; (2) Serum amylase and/or lipase greater than three times the upper limit of normal; and (3) Characteristics findings seen in cross-sectional abdominal imaging. Multiple criteria and scoring systems have been established for assessing severity of AP. The cornerstones of management include aggressive intravenous hydration, appropriate nutrition and pain management. Endoscopic retrograde cholangiopancreatography and surgery are important aspects in management of acute gallstone pancreatitis. We provide a comprehensive review of evaluation and management of AP.

Keywords: Acute pancreatitis; Necrotizing pancreatitis; Resuscitation; Gallstone pancreatitis

Core tip: Acute pancreatitis (AP) is one of the most common gastrointestinal causes for hospitalization in the United States. In 2015, AP accounted for approximately 390000 hospitalizations. The most common cause of AP is gallstones, followed closely by alcohol use. Multiple criteria and scoring systems have been established for assessing severity of AP. The cornerstones of management include aggressive intravenous hydration, appropriate nutrition and pain management. Endoscopic retrograde cholangiopancreatography and surgery are important aspects in management of acute gallstone pancreatitis. We provide a comprehensive review of evaluation and management of AP.