Acute pancreatitis is inflammation of the pancreas that develops quickly. The pancreas is a small organ that plays a crucial role in digestion. Some mild cases of acute pancreatitis resolve without treatment, but severe ones can have potentially fatal complications.

The pancreas is a long, flat gland behind the stomach in the upper abdomen. It produces digestive enzymes and hormones, which regulate how the body processes glucose, for instance.

Pancreatitis is inflammation of the pancreas. It can either be acute, in which case short-term inflammation develops suddenly, or chronic, in which case it is reoccurring or persistent.

The most common cause of acute pancreatitis is gallstones, which can become lodged in a bile or pancreatic duct and cause inflammation. Other common causes include excessive alcohol use, genetic conditions, and the use of certain medications.

Fast facts on acute pancreatitis

  • Pancreatitis is split into acute and chronic types.
  • The pancreas carries out many tasks, including the production of digestive enzymes.
  • Symptoms include pain in the center of the upper abdomen, vomiting, and diarrhea.
  • The most common causes of acute pancreatitis are gallstones and alcohol abuse.

Typically, a person has a sudden onset of pain in the center of their upper abdomen, below the breastbone, or sternum. The pain may intensify and become severe, and it may spread into the back. Leaning forward may ease it, but lying down or walking can make it worse. Anyone with unrelenting pain should receive medical attention.

The following symptoms may also occur:

  • vomiting
  • nausea
  • diarrhea
  • swelling and tenderness of the abdomen
  • a rapid pulse
  • a fever

Treatment for acute pancreatitis depends on its severity. For people with mild cases, the risk of complications is low, and the symptoms may resolve after a few days of rest and treatment. In severe cases, the risk is significant.

Treatment for mild acute pancreatitis

The aim is to maintain bodily functions and ease the symptoms while the pancreas heals itself. The treatment may include:

  • Painkillers: Mild acute pancreatitis can be moderately or severely painful.
  • Nasogastric tubes: These can remove excess liquid and air to relieve nausea and vomiting.
  • Bowel rest: The gastrointestinal tract needs to rest for a few days, so the person will not have any food or drink by mouth until their condition improves.
  • Preventing dehydration: Dehydration often accompanies pancreatitis, and it can worsen the symptoms and complications. Healthcare professionals usually provide fluid intravenously for the first 24–48 hours.

A person can usually return from the hospital after about 5–7 days.

Treatment for severe acute pancreatitis

Severe cases often involve some tissue death, or necrosis. This increases the risk of sepsis, a severe bacterial infection that can affect the whole body. Sepsis can lead to multiorgan damage or failure.

Severe acute pancreatitis can also cause hypovolemic shock. This involves severe blood and fluid loss leaving the heart unable to pump enough blood to the body. If this happens, parts of the body can rapidly become deprived of oxygen. This is a life threatening situation.

Treatment for this kind of pancreatitis includes:

  • Treatment in the intensive care unit (ICU): There, injected antibiotics can help prevent an infection from developing in the dead tissue.
  • Intravenous fluids: These help maintain hydration and prevent hypovolemic shock.
  • Feeding tubes: These provide nutrition, and taking this course early may improve the outcome.
  • Surgery: In some cases, the medical team may recommend surgical removal of the dead tissue.


The patient will stay in the ICU until there is no longer a risk of organ failure, hypovolemic shock, or sepsis.

Treating gallstones

If gallstones are responsible for acute pancreatitis, a doctor may recommend surgery or endoscopic retrograde cholangiopancreatography (ERCP) after the pancreatitis improves. ERCP involves using imaging to diagnose and treat health conditions that affect the bile and pancreatic ducts.

After surgery to remove gallstones, a person may need to have a diet that helps reduce blood cholesterol. This is because excess cholesterol encourages the growth of gallstones.

Also, when gallstones have caused pancreatitis, the American Gastroenterological Association recommends considering surgery to remove the gallbladder to prevent future attacks.

Treating alcohol misuse

If doctors determine that alcohol misuse has caused acute pancreatitis, they may recommend a treatment program for alcohol misuse.

Gallstones and alcohol misuse are the most common causes of acute pancreatitis.

Gallstones

Gallstones are small, pebble-like formations that develop in the gallbladder, often when there is too much cholesterol in the body’s bile.

Sometimes, gallstones become lodged as they travel through bile ducts into the intestines. This blockage affects the pancreas and prevents it from releasing its enzymes into the intestines.

Alcohol misuse

Researchers and medical experts have linked ongoing, substantial consumption of alcohol to a higher risk of acute and chronic pancreatitis.

While the nature of this link remains unclear, alcohol may increase the production of substances that damage pancreatic tissue and lead to severe inflammatory responses.

Other causes

Other possible causes of acute pancreatitis include:

  • infections
  • some autoimmune conditions, such as lupus and Sjögren’s disease
  • specific genetic mutations
  • trauma or injury to the pancreas
  • high triglyceride levels in the blood
  • high calcium levels in the blood
  • certain medications

For a few days during treatment, a person may be unable to eat or need to avoid solid foods. In the hospital, some people require a feeding tube.

When the person starts eating again, the doctor may recommend a healthy low-fat diet with small, regularly paced meals. It is important to drink plenty of fluids, but limit caffeine and avoid alcohol.

Pancreatitis can lead to potentially fatal complications. These can include:

  • the obstruction of a bile or pancreatic duct
  • leakage from a pancreatic duct
  • pseudocysts, with a risk of rupture, hemorrhage, or infection
  • damage to the pancreas
  • a buildup of fluid around the lungs
  • a blockage in a vessel that drains blood from the spleen
  • sepsis
  • hypovolemic shock

Heart, lung, and kidney failure may also occur. Without treatment, these can lead to death.

Anyone with symptoms of acute or chronic pancreatitis should receive medical care as soon as possible.

First, the doctor asks about symptoms and examines the person’s abdomen. If certain areas are sensitive to the touch, this could indicate acute pancreatitis.

In a person with this condition, the abdominal wall muscles are rigid, so when the doctor listens to the abdomen with a stethoscope, there may be very few or no intestinal sounds.

Blood tests

If blood levels of amylase and lipase are higher than normal, the doctor usually sends the person to the hospital. This is because the pancreas produces elevated levels of both chemicals in response to tissue damage, and these enzymes then leak into the blood stream.

However, if the blood test happens outside the first or second day of the illness, the results may be inaccurate. This is because lipase and amylase levels are highest in the first few hours of the illness and return to normal after a few days.

Further testing in the hospital

To determine the cause and risk of complications, the medical team in the hospital may perform:

  • An ultrasound scan: This involves using high-frequency sound waves to create an image of the pancreas, gallbladder, and their surrounding structures.
  • Contrast-enhanced CT scan: This takes pictures of the same area from many angles and combines them to produce a 3D image. It can help identify inflammation of the pancreas, fluid collection, and any changes in the density of the organ.
  • Chest X-ray: This can show areas of collapsed lung tissue or accumulation of fluid in the chest cavity.
  • ERCP: This involves using an endoscope, a thin, flexible tube with a camera, to view the digestive system and determine the exact locations of any gallstones.

Acute pancreatitis usually resolves in a few days with treatment. A person may need to receive this in a hospital, depending on the cause and severity of the condition.

In the U.S., acute pancreatitis is a leading cause of hospital admission due to gastrointestinal disease, resulting in roughly 300,000 hospitalizations a year.

Evidence suggests that there were roughly 2.8 million cases of acute pancreatitis globally in 2019. While there were substantial differences in incidence and mortality across regions, the condition affected roughly 35 in every 100,000 individuals. Approximately 115,053 deaths resulted from acute pancreatitis during that year, with a mortality rate of 1.4 per 100,000 people.