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Acute Pancreatitis


Acute pancreatitis is an inflammation of the pancreas, a condition that affects about 80,000 Americans annually. The pancreas — a large gland located behind the stomach and close to the upper part of the small intestine — secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest the fats, proteins and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it derives from food for energy.

When the pancreas becomes inflamed, the digestive enzymes attack the tissue that produces them. This can lead to tissue damage and bleeding, and cause the pancreas blood cells and blood vessels to swell.

Pancreatitis has two stages — acute and chronic. Chronic pancreatitis is a more persistent condition. Most cases of acute pancreatitis are mild and involve a short hospital stay for the pancreas to recover. Acute pancreatitis occurs suddenly after the pancreas is damaged. In addition, it can be hereditary.

About 20 percent of acute pancreatitis cases are severe. Severe acute pancreatitis can lead to heart, lung or kidney failure, and even death. Some patients may have more than one attack of acute pancreatitis, but typically recover after each one. In the most severe cases, the pancreas and surrounding tissue can die, resulting in shock and sometimes death.

Our approach to acute pancreatitis

UCSF offers state-of-the-art care for a wide range of pancreatic disorders, including acute pancreatitis. Our team includes specialists in gastrointestinal surgery, nursing, nutrition, intensive care, wound care, plastic surgery, pharmacology and infectious diseases. The appropriate specialists for each patient work together to customize a treatment plan.

Treatment for acute pancreatitis depends on the severity of the attack. Patients with mild inflammation are usually hospitalized to receive intravenous fluids and pain medication, as well as antibiotics if there's an infection. Severe cases can be life-threatening and may require surgery. We are experts in the latest minimally invasive techniques and postoperative care. Survival rates for patients treated at our hospital for severe acute pancreatitis are two to three times better than the national average.

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Signs & symptoms

Acute pancreatitis usually begins with a sharp, severe pain in the upper abdomen that may last for a few hours or a few days.

Symptoms include:

  • Constant pain in the upper abdomen, in the back and other areas
  • Pain may be sudden and intense or may begin as a mild pain that is aggravated by eating and drinking
  • Elevated pulse
  • Fever
  • Nausea and vomiting
  • Swollen and tender abdomen


Your doctor will ask about your medical history, perform a physical exam and order blood tests to check for certain enzymes.

During acute attacks, the blood contains at least three times more than the normal amount of digestive enzymes formed in the pancreas. Changes may occur in blood levels of glucose, calcium, magnesium, sodium, potassium and bicarbonate. After the pancreas recovers, these levels usually return to normal.

An abdominal ultrasound to look for gallstones and a computerized tomography (CT) scan to check for injury to the pancreas may be performed.

A procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), may determine if there is a bile duct obstruction. During this procedure, a flexible tube is inserted down the throat into the stomach and small intestines. Dye is injected into the drainage tube of the pancreas to locate a possible obstruction.


Treatment for acute pancreatitis depends on the severity of the attack. Many cases get better with time, unless complications develop. Usually, patients are hospitalized to receive intravenous fluids to restore blood volume and hydration as well as medications to control pain. Antibiotics may be given if an infection occurs.

Dietary guidelines are usually prescribed to reduce the fat you eat, since your body has trouble digesting these substances.


Surgery may be needed if complications such as infection, cysts or bleeding occur. If gallstrones are the cause of your attack, the gallbladder may be removed.

If a bile duct obstruction is suspected of causing the pancreatitis, a procedure called an endoscopic retrograde cholangiopancreatography (ERCP) may be performed. A flexible tube is inserted down the throat into the stomach and small intestines. Dye is injected into the drainage tube of the pancreas to locate the possible obstruction. Special instruments are inserted through the endoscope or tube to remove the obstruction or stretch a narrowing segment of the bile duct.

Patients with severe acute pancreatitis may develop pancreatic necrosis, a serious infection in which tissue within the pancreas dies and later becomes infected. This results in a condition called acute necrotizing pancreatitis. An abscess may form on the dead tissue several weeks after an attack of acute necrotizing pancreatitis.

Surgeons in the Complex Abdominal Surgery Program at UCSF Medical Center have developed surgical techniques for severe acute pancreatitis, including blunt necrosectomy and the minimally invasive, step-up necrosectomy to remove the dead tissue. With new techniques to manage the disease, these procedures result in decreased severity of illness and fewer deaths. The death rate of patients with severe acute pancreatitis at UCSF is two to three times less than the national average.

Patients with severe acute pancreatitis have an average hospital stay of two months, followed by a lengthy recovery period.

Our team of specialists — including those in gastrointestinal surgery, nursing, nutrition, intensive-care medicine, wound care, plastic surgery, pharmacology and infectious disease — work together to customize a treatment plan for each patient.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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