ABSTRACT
This chapter reviews the evidence implicating gallstones in acute pancreatitis, and the theories that account for the association. It discusses the diagnosis, assessment and management of patients with pancreatitis. In the presence of lipaemic serum or in the absence of an obvious aetiology, fasting lipids need to be measured as hypertriglyceridaemia is a cause of acute pancreatitis in up to 5% of cases. The initial presentation however may be indolent with minimal tenderness and constitutional upset, with signs of systemic upset developing only at a later stage. A diagnosis of pancreatitis is dependent on a typical history in the presence of a markedly elevated serum amylase. The procedure may be performed in the radiology suite, but for intubated patients screening radiology can be used on the intensive care unit itself. Morbidity and mortality may be increased in patients with acute biliary pancreatitis who undergo laparoscopic cholecystectomy within the first week of an attack.
