Acute Pancreatitis: Review and Clinical Update

Hospital Physician January 2009 A cute pancreatitis describes an acute inflammatory process of the pancreas that can range from mild interstitial pancreatitis to severe pancreatitis with pancreatic necrosis and concomitant multiorgan failure. Acute pancreatitis is typically rapid in onset and most commonly encountered in its mild form. In 2005, more than 230,000 patients were treated for acute pancreatitis in hospitals in the United States.1 Recent studies have demonstrated an increase in the incidence of acute pancreatitis, and some have projected substantially higher incidence rates than previously reported, although case-fatalities have remained stable since 1970.2 The increased frequency of acute pancreatitis may be due to the rising incidence of obesity, a risk factor for the development of gallstones and, by extension, gallstone pancreatitis.3 Acute pancreatitis confers a heavy financial burden on the health care system and significant physiologic stress on the patient. A recent study estimated that the average cost per hospitalization for acute pancreatitis is $9870.4 Acute pancreatitis is responsible for $2.2 billion in US health care expenditures annually. The average length of hospital stay for a patient with acute pancreatitis is approximately 5 to 6 days.2,5,6 In addition, acute pancreatitis may be accompanied by life-threatening complications as well as significant morbidity and mortality. This article reviews the diagnosis and management of patients with acute pancreatitis.