Acute pancreatitis is acute inflammation of the pancreas and the most common disorder of the organ. Most episodes are mild and resolve within a week, while a minority progress to persistent organ failure or pancreatic necrosis, and where an episode sits on that range from mild to severe shapes both how it is assessed and how it is treated.
A sound route through the subject starts with how the gland injures itself and what triggers an attack, moves to how the attack is recognised and graded, and ends with the severe forms and their management:
- Pathogenesis explains how trypsinogen is activated inside the acinar cell and how that local injury becomes a systemic inflammatory illness.
- Predisposing Conditions reviews the causes, led by gallstones and alcohol, and the clues that separate the two commonest.
- Epidemiology covers how often acute pancreatitis occurs, how that has changed, and how its causes are distributed.
- Definition and Classification gives the two-of-three diagnostic criteria and the mild, moderately severe and severe grades.
- Clinical Presentation describes the pain, vomiting and examination findings of an attack.
- Laboratory Findings covers what lipase and amylase add and where each misleads.
- Imaging explains what CT, MRI, ultrasound and plain radiography each contribute.
- Severity Prediction reviews the clinical, laboratory and radiological predictors and the scoring systems built from them.
- Clinical Course describes the early systemic phase and the later phase of local complications.
- Complications covers the collections and the terminology of interstitial and necrotising disease.
- Management covers fluids, nutrition, antibiotics, ERCP, cholecystectomy and the treatment of necrosis.
A reader new to the topic should begin with Pathogenesis and Predisposing Conditions, which explain why the disease happens; the later notes build on that footing.