Management and Treatment of Acute Pancreatitis

*Please note: This slide set represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.

In acute pancreatitis, the digestive enzymes are activated prematurely and start to attack the pancreas. This causes inflammation, leading to symptoms that are often severe enough to require hospitalization.

Alcohol abuse and gallstones are the main triggers of acute pancreatitis.

Treatment options for acute pancreatitis depend on the severity of the condition. Initial treatment of acute pancreatitis is supportive. The focus is on resting the pancreas and managing the pain.

Since the pancreas is stimulated by eating, food and drinks are restricted and the patient is put on intravenous fluids to help maintain hydration. Medication for pain and vomiting may also be administered intravenously.

Most people who develop acute pancreatitis only require a few days of hospitalization.

However, about 1 in 10 cases are more serious and require treatment in the intensive care unit.

The kidneys and lungs can be affected, which may require dialysis or placement of a breathing tube.

Fluid-filled sacks (or pseudocysts) can also form inside the pancreas. If they become infected or cause symptoms like abdominal pain, gastric outlet obstruction (nausea and vomiting) or biliary obstruction (elevation in liver test), they will require drainage.

Surgery is sometimes needed to remove dead or infected pancreatic tissue or tissue around the pancreas.

Some specialised hospitals can drain fluid without surgery, using endoscopic methods where the drainage tube is inserted into the stomach or small bowel, or using a percutaneous procedure where a small drainage tube is inserted through the skin.

If gall bladder disease was the root cause of the pancreatitis, then the gall bladder may also be removed to prevent future attacks.

Most people recover from acute pancreatitis and are offered specific lifestyle advice to prevent future attacks, which can lead to a chronic, or on-going, form of the disease.

Patients are advised to avoid alcohol and high fat foods, stop smoking, eat a varied diet that is rich in fruits and vegetables, and keep triglyceride levels in the normal range. Medications that put stress on the pancreas must also be avoided.

However some people never recover fully from an attack. In rare cases, the pancreas becomes so damaged that it no longer functions properly. This is called pancreatic insufficiency.

In rare occasions, the pancreatitis can be so severe, that may lead to pancreatic insufficiency, diet is further restricted and life-long medication (pancreatic enzyme supplementation) is required.