Acute Pancreatitis

Acute pancreatitis is an acute inflammatory injury of the pancreas. A patient with abrupt, persistent epigastric pain radiating to the back and a lipase at least three times the laboratory upper limit of normal already meets the Canadian two-of-three diagnostic rule. The immediate priorities are to assess airway, breathing, circulation, mental status and organ function; start appropriate supportive care; and identify the cause. Routine admission CT is not required when the clinical and laboratory criteria establish the diagnosis. The diagnostic rule confirms acute pancreatitis but does not determine severity. A high enzyme concentration does not by itself prove severe disease. Repeated bedside assessment is essential because systemic inflammation, capillary leak and intravascular volume depletion can evolve into respiratory, renal or cardiovascular organ failure. Conversely, excessive fluid can cause pulmonary or peripheral fluid overload. The NP therefore integrates symptoms, examination, laboratory trends, response to treatment and local consultation pathways rather than relying on one laboratory result or score.