Gastroenterology
Pancreatitis
Pancreatitis is an inflammatory disorder of the pancreas that ranges in severity from mild, self-limiting cases to severe, life-threatening disease requiring intensive care. It is broadly categorized into acute pancreatitis (AP) and chronic pancreatitis (CP), both of which can lead to significant morbidity and mortality, particularly in critically ill patients.
Acute pancreatitis can result from various causes, including gallstones, alcohol use, and metabolic disturbances. Severe cases may progress to systemic inflammatory response syndrome (SIRS), multiorgan dysfunction, and necrotizing pancreatitis, necessitating aggressive supportive care, antimicrobial stewardship, and potential surgical intervention. Chronic pancreatitis, on the other hand, is characterized by persistent inflammation leading to fibrosis, pancreatic insufficiency, and long-term complications.
This section compiles key clinical guidelines and expert reviews to provide healthcare professionals with evidence-based strategies for the diagnosis, management, and treatment of pancreatitis. From initial assessment and risk stratification to advanced interventions in severe cases, these resources serve as a critical reference for optimizing patient outcomes.
Acute pancreatitis management
International Association of Pancreatology Revised Guidelines on Acute Pancreatitis 2025
IAP/APA/EPC/IPC/JPS Working Group, Pancreatology (2025)
What’s inside
The 2025 IAP/APA/EPC/IPC/JPS guidelines provide updated, evidence-based recommendations for the management of acute pancreatitis (AP), covering 18 domains and 96 clinical questions. Key updates include refined diagnostic criteria, severity prediction, fluid therapy, nutritional support, antibiotic use, and interventional strategies for necrotizing pancreatitis.
Why it’s relevant
Acute pancreatitis is a leading cause of gastrointestinal hospitalization, with severe cases carrying high morbidity and mortality. These guidelines standardize management across global centers, emphasizing early risk stratification, targeted interventions, and multidisciplinary care to improve outcomes and reduce complications.
Key focus
- Diagnosis: Two of three criteria (abdominal pain, elevated enzymes, imaging findings)
- Severity prediction: SIRS, CRP, IL-6, and persistent organ failure
- Fluid therapy: Lactated Ringer’s solution, moderate infusion rates
- Nutrition: Early oral/enteral feeding, polymeric formulations
- Interventions: Step-up approach for infected necrosis, timing of drainage/necrosectomy