Acute Pancreatitis

Acute pancreatitis is one of the most difficult diseases a clinician can manage. The systemic inflammatory response syndrome can be severe in these animals. Major organ failure – refractory hypotension, liver failure, gastrointestinal failure, ARDS (acute respiratory distress syndrome), and DIC (disseminated intravascular coagulation) may develop. Only through aggressive medical management and sometimes surgical management can the clinician hope to minimize morbidity and mortality. Commonly used diagnostic tests do not necessarily correlate with severity of disease or prognosis, which means that the clinician should treat all pancreatitis patients as having potentially life-threatening disease. The ultimate diagnosis of pancreatitis is a histopathologic one which is rarely achieved. Aggressive fluid therapy, analgesia and nutritional support form the cornerstone of therapy. If patients have necrotic, abscessed or neoplastic pancreatic tissue present, the inflammatory process may not subside until the affected tissue is debrided. Surgery is rarely indicated but may be important in the management of some patients. […]