UK guidelines for the management of acute pancreatitis

Correspondence to: Mr C D Johnson, University Surgical Unit, Mail Point 816, Southampton General Hospital, Southampton BH24 4EW, UK; c.d.johnson@ soton.ac.uk . . . . . . . . . . . . . . . . . . . . . . . 1.0 REVISED RECOMMENDATIONS AND AUDIT STANDARDS 1.1 Recommendations 2003 (*Unchanged from the 1998 recommendations) Diagnosis N *The correct diagnosis of acute pancreatitis should be made in all patients within 48 hours of admission (recommendation grade C). N The aetiology of acute pancreatitis should be determined in at least 80% of cases and no more than 20% should be classified as idiopathic (recommendation grade B). N Although amylase is widely available and provides acceptable accuracy of diagnosis, where lipase estimation is available it is preferred for the diagnosis of acute pancreatitis (recommendation grade A). N Where doubt exists, imaging may be used: ultrasonography is often unhelpful and pancreatic imaging by contrast enhanced computed tomography provides good evidence for the presence or absence of pancreatitis (recommendation grade C).