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Previous Volume 354:2142-2150 May 18, 2006 Number 20 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 56-year-old woman presents with severe epigastric pain and vomiting of 14 hours' duration, symptoms that had developed shortly after dinner the previous night. She has no history of alcohol use, takes no medications, and has no family history of pancreatitis. On physical examination, she has a heart rate of 110 beats per minute and moderate epigastric abdominal tenderness without peritoneal signs. . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Management

            Imaging Studies

            ERCP

            Hospitalization

            Predicting Severe Acute Pancreatitis

            Pancreatic-Fluid Collections, Pseudocysts, and Necrosis

            Lack of Improvement

            Use of Antibiotics

            Nutritional Support

            Surgery

            Discharge Planning

Areas of Uncertainty

Guidelines

Summary and Recommendations

Source Information

From the Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh.

Address reprint requests to Dr. Whitcomb at the University of Pittsburgh Medical Center Presbyterian, Mezzanine Level 2, C Wing, 200 Lothrop St., Pittsburgh, PA 15213, or at whitcomb@pitt.edu.

Related Letters:

Acute Pancreatitis
Famularo G., Minisola G., De Simone C., Whitcomb D. C.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:961, Aug 31, 2006. Correspondence

This article has been cited by other articles:

• Swisher, K. K., Doan, J. T., Vesely, S. K., Kwaan, H. C., Kim, B., Lammle, B., Kremer Hovinga, J. A., George, J. N. (2007). Pancreatitis preceding acute episodes of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: report of five patients with a systematic review of published reports. haematol 92: 936-943 [Abstract] [Full Text]  
• Hayashi, T., Ishida, Y., Kimura, A., Iwakura, Y., Mukaida, N., Kondo, T. (2007). IFN-{gamma} Protects Cerulein-Induced Acute Pancreatitis by Repressing NF-{kappa}B Activation. J. Immunol. 178: 7385-7394 [Abstract] [Full Text]  
• Famularo, G., Minisola, G., De Simone, C., Whitcomb, D. C. (2006). Acute pancreatitis.. NEJM 355: 961-961 [Full Text]