How Should I Manage My in the Pancreatitis Patients Emergency Department? Who Needs Imaging? Antibiotics? Surgery? Interventional Radiology? ERCP?
The mainstay of treatment for acute pancreatitis is early, aggressive fluid administration and pain control. Antibiotics are not routinely recommended and should be used only if an infection is present or suspected; they should be discontinued if no infectious source is found. Imaging should be reserved for patients in whom the diagnosis is unclear or complications are suspected. Surgical intervention should be delayed if possible. A step-up approach to surgical management has shown some promise in severe pancreatitis patients and may involve interventional radiology for drain placement. A cholecystectomy is recommended for patients with gallstones. ERCP is recommended for patients with signs of biliary obstruction or cholangitis, but it is not recommended routinely.
KeywordsAcute pancreatitis Antibiotics Imaging Surgery ERCP
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