On-going Management beyond the ED – Surgery and Aetiology

Surgery is really only reserved for selected cases when pancreatitis is complicated by pancreatic or peripancreatic (abdominal fatty tissue) necrosis; the timing of surgery will be dependent on many factors including the patient’s clinical condition, presence of infection and degree of necrosis, and is largely the surgical team’s decision.

The aetiology of the pancreatitis should be attempted to be determined if it has not already; a diagnosis of idiopathic disease should not be made until a thorough consideration of other causes has been made. This may necessitate revisiting the history, further abdominal USS, magnetic resonance cholangiopancreatography (MRCP), endoscopic USS, viral antibody titres, autoimmune markers and ERCP.

Learning Bite

Good supportive care rather than surgery is the mainstay of the management of pancreatitis.

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