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= Paid-up subscribersGastroenterology:Managing acute and chronic pancreatitis
21 Oct 2010
In western societies about 80% of AP diagnoses occur secondary to gallstone disease and alcohol misuse. In the UK, AP is currently diagnosed in 150-420 per million population per annum, with a male to female ratio of 1.9:1.1 The incidence of AP in the UK has doubled since the 1960s, rising particularly in women under the age of 35 (by 11% per annum), which may be associated with altered patterns of alcohol consumption. AP of any cause can result in the initiation of multiple inflammatory cascades and the systemic inflammatory response syndrome, which can lead to multi-organ failure and even death early in the course of disease. If the disease is severe or prolonged, third space fluid losses and hypoperfusion can result in pancreatic necrosis, which is particularly susceptible to infection, and is responsible for most late deaths occurring secondary to acute pancreatitis. CP follows continued, repetitive or sustained injury to the pancreas, and 70% of diagnoses occur secondary to alcohol abuse. The pain and weight loss associated with CP remain extremely challenging to manage and all patients whose pain or weight loss is inadequately managed in the community setting should be referred for multidisciplinary assessment and consideration of interventional therapies.
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