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Phases of acute pancreatitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

phases of acute pancreatitis

Two overlapping phases with two peaks of mortality can be identified in acute pancreatitis:

  • early phase
    • present during the first week (but may extend to the second week as well)

    • host response to local pancreatic injury will result in systemic disturbances which will clinically manifest as the systemic inflammatory response syndrome (SIRS)
      • SIRS - defined by presence of two or more criteria:
        • heart rate >90 beats/min
        • core temperature <36°C or >38°C
        • white blood count <4000 or >12000/mm3
        • respirations >20/min or PCO2 <32mmHg

    • the severity of acute pancreatitis during early phase is determined by the presence and duration of organ failure
      • persistent SIRS (>48 hours) has been shown to be strongly associated with subsequent risk of developing organ failure

    • local complications may be present but does not influence the severity of the condition

  • late phase
    • characterised by the continuation of systemic signs of inflammation or by the presence of local complications
    • seen only in patients with moderately severe or severe acute pancreatitis (1,2)

Reference:

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