🔥 Acute Pancreatitis Severity & Management
This tool stratifies acute pancreatitis by revised Atlanta severity and gives fluid, nutrition, ERCP, and antibiotic direction by biliary and infection status.
Acute Pancreatitis Severity & Management
Severity (revised Atlanta)
Biliary etiology
Concomitant cholangitis or persistent biliary obstruction
Infected pancreatic necrosis or extrapancreatic infection
When to use
Use to set goal-directed resuscitation, early enteral nutrition, and ERCP/antibiotic decisions, escalating severe disease to the ICU.
How it works
Severity: mild (no organ failure), moderately severe (transient OF < 48 h or local complications), severe (persistent OF > 48 h). Goal-directed crystalloid; EN within 48–72 h; ERCP only for biliary + cholangitis/obstruction; antibiotics only for infection.
Key points
- Prophylactic antibiotics are withheld in the absence of infection, and over-resuscitation is actively avoided because it worsens tissue edema. (original synthesis · not guideline verbatim)
- Emergency ERCP is reserved for biliary pancreatitis with cholangitis or persistent obstruction.
- Biliary cases get cholecystectomy after recovery to prevent recurrence.
References
- Banks PA, et al. Classification of acute pancreatitis — 2012: revision of the Atlanta classification. Gut 2013.
- Crockett SD, et al. AGA Institute Guideline on Initial Management of Acute Pancreatitis. Gastroenterology 2018.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.