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Nishmi Gunasingam and Alina Stoita
Acute pancreatitis (AP) is an inflammatory disorder of the pancreas. Majority of cases will recover without complications, but the remainder will have severe disease. It is the most common gastrointestinal disorder that requires hospitalisation. Gallstones and alcohol are the leading culprits. Stratifying severity using the revised Atlanta Classification is of paramount importance. Important aspects of management include fluid resuscitation in the first 24 hours and adequate opiate analgesia. Endoscopic retrograde cholangio pancreatography (ERCP) should be performed within 24 hours in patients with biliary pancreatitis and concurrent cholangitis. Cholecystectomy should be performed in the index admission in cases of mild biliary pancreatitis. Complications of severe pancreatitis should be managed in a multidisciplinary centre with expertise in management of the more complex aspects of the condition including pseudocysts and walled off pancreatic necrosis. This article will explore the aetiology, diagnosis and current advances in the treatment of acute pancreatitis.