Key PrinciplesAggressive fluid resuscitation and pain managementEarly ERCP if indicatedEarly enteral feeding (preferably via NG route)Avoid early surgical intervention for necrotic pancreatitisVigilant supportive care to avoid complications Initial Resuscitation &...
A number of systems exist to identify severity and prognosticate pancreatitis Considered advantageous over clinical judgement alone Useful in determining optimum location of care Limitations exist with many of the scoring systems: Cumbersome to complete Require 48...
CT is indicated if the diagnosis is equivocal, to rule out alternative intra-abdominal catastrophes In acute severe pancreatitis, CT is used to detect and stage regional complications such as pancreatic necrosis: Should be performed in those with new or persisting...
Abdominal X-ray Chest X-ray Chest US Abdominal US Endoscopic Ultrasound Renal Tract US Contrast-Enhanced CT MRI/MRCP Angiography Ileus, loss of psoas shadow, sentinel loop, pancreatic calcification, and calcified gallstones Pleural effusions (usually on left) and...
An ultrasound of the RUQ should be performed in all cases to assess for biliary stones and obstruction After negative routine work-up for biliary aetiology, endoscopic ultrasonography (EUS) is recommended as the first step to assess for occult microlithiasis,...
