Overview
Alcohol-induced acute pancreatitis (AP) is an inflammatory condition of the pancreas. It is a common cause of AP, particularly in Western countries.Diagnosis
Diagnosis of AP is based on the presence of at least two of the following three features: characteristic abdominal pain, serum amylase or lipase activity at least three times the upper limit of normal, or characteristic findings of AP on cross-sectional imaging 1.
Imaging modalities such as contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) can be used for diagnosis and assessment of severity 1.Management
Management of AP is primarily supportive and includes fluid resuscitation, pain control, and nutritional support 1.
Early enteral nutrition is generally preferred over parenteral nutrition when feasible 1.
Antibiotics are typically reserved for patients with documented infected pancreatic necrosis 1.Special Populations
In pregnant women, the incidence of AP increases with gestational age, with the third trimester having the highest incidence 1.
Major causes of AP in pregnancy include hypertriglyceridaemia and biliary pancreatitis 1.
Maternal mortality in AP during pregnancy is approximately 1.84 percent, and fetal mortality is approximately 10.18 percent 1.Key Recommendations
Diagnosis of acute pancreatitis requires at least two of the following: characteristic abdominal pain, elevated amylase/lipase, or characteristic imaging findings 1. (Evidence: Moderate)
Supportive management including fluid resuscitation, pain control, and nutritional support is the cornerstone of treatment for acute pancreatitis 1. (Evidence: Moderate)
Enteral nutrition should be initiated early in patients with acute pancreatitis when feasible 1. (Evidence: Moderate)
Antibiotics should be administered only for documented infected pancreatic necrosis 1. (Evidence: Moderate)
In pregnant patients, the incidence of acute pancreatitis increases with gestational age, with hypertriglyceridaemia and biliary causes being the most common etiologies 1. (Evidence: Moderate)References
1 Haiyan Z, Na P, Yong G, Xiumei B, Jianying B. Impact of acute pancreatitis during pregnancy in Chinese women: a meta-analysis. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 2022. link