[Acute pancreatitis. 1: Principles of conservative therapy]

Any patient with suspected acute pancreatitis should be hospitalized in an intensive care unit. Since the course even of an apparently initially uncomplicated attack of pancreatitis can rapidly become severe and life-threatening, close clinical monitoring in accordance with the rules of critical care medicine is necessary. The major therapeutic measures comprise fasting, parenteral replacement of fluid, electrolytes and calories, and pain treatment. The care of patients with acute pancreatitis should be a joint effort on the part of the internist and the surgeon right from the start. At the present time, there is no specific treatment regimen for pancreatitis. Therapeutic concepts of hormonal inhibition of pancreatic secretion, or the inactivation of autodigestive enzymes, have not proved successful, or have not yet been adequately demonstrated to be effective. On resolution of the pancreatitis, an attempt must always be made to identify the cause of cause of the condition, since this forms the basis for further prophylactic and therapeutic consequences.