Acute pancreatitis (AP) is an acute inflammatory process of the pancreas in which pancreatic enzymes are released and autodigest the gland with effects ranging from edema to necrosis. Acute pancreatitis has a wide spectrum of disease from a mild, transitory illness to a severe, rapidly fatal disease. Approximately 80% of patients with the disease have a mild acute interstitial edematous pancreatitis with a low morbidity and mortality rate (≤1%). Mild pancreatitis is usually self-limiting, subsiding in most cases uneventfully within 3 to 4 days and rarely needing intensive care treatment or pancreatic surgery. Severe or necrotizing pancreatitis develops in about 20% of patients, early death within 1 week of admission is related to systemic inflammatory response syndrome (SIRS), with infection of pancreatic and peripancreatic necrosis representing the single most important risk factor for a fatal outcome. Overall, AP is complicated by infection in approximately 10% of patients and is associated with 70% to 80% mortality. The greater the amount of necrotic reaction, the greater the risk of subsequent infection of the gland. The prognosis and severity of a pancreatitis attack may be assessed by monitoring clinical signs and symptoms. The clinical findings in severe disease may include the presence of hypotension, hypoxemia, renal failure, and hemo-concentration reflective of intravascular volume loss. Other findings may include abdominal pain and nausea, fever (>38.6°C [101.5°F]), ascites, and ecchymosis.
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