phases of acute pancreatitis

Last reviewed 06/2021

phases of acute pancreatitis

Two overlapping phases with two peaks of mortality can be identified in acute pancreatitis:

• early phase
• present during the first week (but may extend to the second week as well)
  
  
• host response to local pancreatic injury will result in systemic disturbances which will clinically manifest as the systemic inflammatory response syndrome (SIRS)
• SIRS - defined by presence of two or more criteria:
• heart rate >90 beats/min
• core temperature <36°C or >38°C
• white blood count <4000 or >12000/mm3
• respirations >20/min or PCO2 <32mmHg
  
  
• the severity of acute pancreatitis during early phase is determined by the presence and duration of organ failure
• persistent SIRS (>48 hours) has been shown to be strongly associated with subsequent risk of developing organ failure
  
  
• local complications may be present but does not influence the severity of the condition
  
  
• late phase
• characterised by the continuation of systemic signs of inflammation or by the presence of local complications
• seen only in patients with moderately severe or severe acute pancreatitis (1,2)

Reference:

• (1) Banks PA et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. 
• (2) Johnson CD, Besselink MG, Carter R. Acute pancreatitis. BMJ. 2014;349:g4859