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In the Clinic |

Acute Pancreatitis

Kapil Gupta, MD, MPH; and Bechien Wu, MD, MPH
Ann Intern Med. 2010;153(9):ITC5-1. doi:10.7326/0003-4819-153-9-201011020-01005
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Acute pancreatitis is an acute inflammatory process of the pancreas that can occur as an isolated event or relapsing episodes. Acute pancreatitis is a heterogeneous disease ranging from minimal pancreatic inflammation seen in mild interstitial pancreatitis to extensive pancreatic necrosis and liquefaction of severe attacks. Diagnosis is based on the presence at least 2 of 3 features: abdominal pain; increased pancreatic enzyme, amylase, and/or lipase levels to ≥3 times the upper limit of normal; and imaging tests showing characteristic findings of acute pancreatitis (1). Alcohol and gallstones are the two most common causes, but there are many less common causes. Acute pancreatitis accounts for more than 200 000 hospital admissions annually in the United States, and incidence has been increasing (2). The rates of acute pancreatitis per 1000 Americans 40 to 59 years of age are the highest they have been in the past 20 years, and rates are higher for blacks than for whites. Mortality from acute pancreatitis is <5% overall, but severe attacks cause longer hospitalization and significantly higher mortality (3). The annual relapse rate of acute pancreatitis ranges from 0.6% to 5.6%, depending on the cause, and is highest when pancreatitis results from alcohol consumption (4).

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