On-going Management beyond the ED – Key to Successful Management

The key to the successful management of a patient with pancreatitis is that of good supportive care, with surgery having a very limited role [5]. Accurate fluid management is essential and, in severe cases, this may require invasive monitoring and/or inotropes administered in a critical care area. Patients should be watched for the development of complications and this includes serial clinical assessment, labs and imaging.

Importantly, serial measurements of serum amylase or lipase after diagnosis have limited value in assessing the clinical progress of the illness or prognosis [9].

Patients with persisting organ failure, signs of sepsis, or deterioration in clinical status after admission will require CT [10].

Early ERCP is useful in patients with an obstructing gall stone in the common bile duct as the cause, although early cholecystectomy is not warranted [5].

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