Updated management of acute pancreatitis in intensive care medicine

Acute pancreatitis is defined as acute inflammation of the pancreas. The diagnosis of the condition is made on the basis of three key factors: epigastric pain, elevated enzymes levels and abnormal imagine tests. The classification of such cases is determined by the presence or absence of organ failure and the stage of (peri)pancreatic necrosis. Cases with persistent organ failure should be referred to the Intensive Care Unit. Management strategies emphasize supportive measures, adequate hydration, effective pain management, and the early initiation of nutrition. The use of antibiotics as a prophylactic measure is to be avoided. Surgery is indicated in cases of hollow organ perforation, intestinal ischemia, or failure of medical treatment in compartment syndrome. In general, the management of infected necrosis should be conservative or minimally invasive. However, should the condition develop before encapsulation and be associated with organ failure, noninvasive drainage is indicated. If such management proves ineffective, open necrosectomy should be considered.