American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis.Crockett SD, Wani S, Gardner TB, Falck-Ytter Y, Barkun AN; American Gastroenterological Association Institute Clinical Guidelines Committee. Gastroenterology. 2018 Mar;154(4):1096-1101

This document presents the official recommendations of the American Gastroenterological Association (AGA) on the initial management of acute pancreatitis (AP).

The guideline was developed by the AGA’s Clinical Practice Guideline Committee and approved by the AGA Governing Board. It is accompanied by a technical review that is a compilation of the clinical evidence from which these recommendations were formulated.AP is an inflammatory condition of the pancreas that can cause local injury, systemic inflammatory response syndrome, and organ failure. Worldwide, AP is a common gastrointestinal condition that is associated with substantial suffering, morbidity, and cost to the health care system. In the United States, AP is a leading cause of inpatient care among gastrointestinal conditions: >275,000 patients are hospitalized for AP annually, at an aggregate cost of >$2.6 billion per year. The incidence of AP ranges from 5 to 30 cases per 100,000, and there is evidence that the incidence has been rising in recent years. The overall case fatality rate for AP is roughly 5%, and is expectedly higher for more severe disease.Patients with AP frequently experience abdominal pain, nausea, and vomiting, and the condition negatively impacts quality of life. The most common causes of AP remain gallstones and alcohol, which together comprise 80% of cases; the remainder of cases are due to less common causes, including drug reactions, pancreatic solid and cystic malignancies, and hypertriglyceridemia.

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