[Acute pancreatitis: diagnosis and therapeutic principles]

The diagnosis of acute pancreatitis is based on the association of acute upper abdominal pain and hyper lipasemia. The CT scan confirms the diagnosis and assess the severity of the pancreatitis, as do several bioclinical indexes. Alcohol and biliary lithiasis, seeked by ultrasound, are the two main causes of acute pancreatitis. Most of acute pancreatitis are oedematous and resolve spontaneously without sequella. Severe necrotizing pancreatitis lead to death in 10 to 20% of cases, because of multiple organ failure or intra-abdominal complications of necrosis. Treatment of severe acute pancreatitis involves intensivists, radiologists and surgeons. Surgery is restricted to drainage of super-infected necrosis and treatment of causative biliary lithiasis.