Evidence-Based Critical Care - Ch 36, Pancreatitis

Abstract

Acute pancreatitis is a common disease that causes significant morbidity and mortality. Pancreatitis is the most common principle gastrointestinal discharge diagnosis in the United States [1]. More than 250,000 patients are admitted per year for pancreatitis and about 3,000 die from this disease per year in the US [1, 2]. Furthermore, the hospitalization rate for acute pancreatitis in the US is rising [2]. About 15 % of all patients with acute pancreatitis develop necrotizing pancreatitis. Mortality ranges from 3 % for patients with interstitial edematous pancreatitis to 15 % for patients who develop necrosis [3, 4]. In developed countries, obstruction of the common bile duct by stones (38 %) and alcohol abuse (36 %) are the most frequent causes of acute pancreatitis. Gallstone-induced pancreatitis is caused by duct obstruction of gallstone migration. Obstruction is localized in the bile duct, the pancreatic duct, or both. Other well established causes of acute pancreatitis include: