[ACUTE PANCREATITIS]

Abstract

Acute pancreatitis is an inflammation of the pancreas due to intrinsic enzymatic activation. It is related to a wide spectrum of etiological associations, pathological findings and clinical courses.The etiology can be classified as obstructive and non obstructive, being alcohol and galistones the most frequent ones. The pathogenesis is based on an intrinsic activation of pancreatic proenzymes which leads to an inflammatory response mediated by proinflammatory factors, and the generation of free radicals in the process.From the pathological standpoint, acute pancratitis has been classified as interstitial and necrotizing. Complications may arise due to the generation of fluid collection, pseudocyst and abscess. These structural distortions are the foundations for clinical forms categorized as mild and severe pancreatitis, respectively. The last one is characterized by the presence for systemic and/or local complications. Its diagnosis is based on the confirmation of the disease and its level of severity. These objetives are met by the clinical and auxiliary set of symptons established by determining the relation between the amylase clearance and the creatinine clearance, and the risk factor prognosis as the main parameters.To treat acute pancreatitis it is necessary to manage its complications. The primary aims are to optimize the patient's hemodynamics; to monitorize and keep his/her respiratory status; to provide nutritional support, and to handie eventual infections. Once the patient is compensated, we will proceed with the etiologic evaluation and treatment.