ABSTRACT
Acute pancreatitis is particularly common in Western populations, with alcoholic pancreatitis being more prevalent in the USA, and gallstone-related pancreatitis occurring more frequently in Europe. Gallstones and alcohol are the major causes of acute pancreatitis. The inflammatory process that is seen in acute pancreatitis is allied to several cytokines, including TNF, IL-1, IL-6 and IL-8. Pancreatic enzymes can cause the erosion of blood vessels in the proximity of the pancreas. Surgical management is now rarely used in cases of acute pancreatitis, as the surgical role has diminished with the advent of minimally invasive interventional techniques. Initial management relies on aggressive resuscitation measures, particularly in the setting of sepsis and shocked patients. Patients typically present with abdominal pain, which is commonly dull in character, and often extremely severe. Discussion of cases of patients with severe acute pancreatitis is important, as this will ensure that these patients are commenced on the correct enteral nutrition programmes.
