Diagnosis and management of pancreatitis

While there is no single diagnostic approach, other than direct examination of the pancreas, that is completely reliable for the diagnosis of pancreatitis, a presumptive diagnosis of acute pancreatitis can be made with a good degree of confidence by careful evaluation of the entire clinical picture ‐ history and clinical signs, results of physical examination, abdominal imaging and laboratory testing. The approach to treatment is to rest the pancreas, by withholding food, while providing general supportive care by fluid therapy including, in severe cases, plasma transfusion to replace plasma protease inhibitors and albumin. Additional specific interventions in an effort to halt the progression of spontaneous pancreatitis have not yet been shown to be effective, but control of obesity and avoidance of high fat diets may help prevent pancreatitis or lessen its severity when it occurs. Pancreatitis is an unpredictable disease of widely varying severity. While many patients with uncomplicated pancreatitis recover spontaneously following several days of supportive care, other patients die in spite of prolonged intensive care.